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 |