| NPI | 1699514869 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KRISTOPHER CRAWFORD Owner 999-999-9999 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine |
| Additional Taxonomies | 207P00000X Emergency Medicine |
| Enumeration Date | 2024-05-20 |
| Last Update Date | 2024-05-20 |