| NPI | 1649555467 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | OLUROTIMI JOHN BADERO Registered Agent 601-750-5736 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207RI0011X Internal Medicine, Interventional Cardiology (Licence: MS 21527) |
| Additional Taxonomies | 207RN0300X Internal Medicine, Nephrology (Licence: MS 21527) |
| Enumeration Date | 2011-10-12 |
| Last Update Date | 2013-12-11 |