| NPI | 1639658271 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MILISH RISBOOD President 888-291-1358 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine |
| Additional Taxonomies | 363L00000X Nurse Practitioner |
| Enumeration Date | 2018-08-13 |
| Last Update Date | 2018-09-25 |