| NPI | 1659329852 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KRISTINA MUSIC Director,Provider Enrollment 877-892-9815 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine |
| Additional Taxonomies | 207Q00000X Family Medicine |
| 207V00000X Obstetrics & Gynecology | |
| 207X00000X Orthopaedic Surgery | |
| 208000000X Pediatrics | |
| 208800000X Urology | |
| 208M00000X Hospitalist | |
| 363L00000X Nurse Practitioner | |
| 363LA2200X Nurse Practitioner, Adult Health | |
| Enumeration Date | 2006-05-04 |
| Last Update Date | 2024-09-23 |