| NPI | 1689833600 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CLYDE CLYBOURN Owner/Provider 302-242-2399 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: TX M7914) |
| Enumeration Date | 2008-06-05 |
| Last Update Date | 2008-06-20 |