| NPI | 1639865546 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LAWRENCE A UKPONG President 229-891-9087 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207RC0000X Internal Medicine Cardiovascular Disease |
| Enumeration Date | 2023-04-13 |
| Last Update Date | 2023-04-13 |