NPI | 1649491606 |
---|---|
Entity Type | Organization |
Authorized Contact | MIKE SYRU CHIANG Doctor 229-241-1188 |
Organization Subpart ? | No |
Primary Taxonomy | 174400000X Specialist (Licence: GA 018627) |
Additional Taxonomies | 174400000X Specialist (Licence: GA 18627) |
Enumeration Date | 2007-05-01 |
Last Update Date | 2017-07-05 |