| NPI | 1679341523 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DOUGLAS ELWOOD Owner 347-218-0393 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine |
| Additional Taxonomies | 207Q00000X Family Medicine |
| Enumeration Date | 2023-12-19 |
| Last Update Date | 2024-10-07 |