| NPI | 1699067264 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DIRK F PARVUS President 772-564-7887 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207QA0505X Family Medicine Adult Medicine (Licence: FL ME0066484) |
| Enumeration Date | 2011-05-13 |
| Last Update Date | 2011-09-28 |