| NPI | 1619454295 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JOY K SENSAKOVIC Owner 239-301-0897 |
| Organization Subpart ? | No |
| Primary Taxonomy | 208D00000X General Practice |
| Additional Taxonomies | 363A00000X Physician Assistant |
| Enumeration Date | 2018-07-26 |
| Last Update Date | 2018-07-26 |