| NPI | 1679168512 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | EVAN BERG Chief Executive Officer 833-946-7833 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine |
| Additional Taxonomies | 163W00000X Registered Nurse |
| 207P00000X Emergency Medicine | |
| 207Q00000X Family Medicine | |
| Enumeration Date | 2021-03-03 |
| Last Update Date | 2024-10-28 |