| NPI | 1700658036 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | BAPTISTE MARINO Owner 980-262-3007 |
| Organization Subpart ? | No |
| Primary Taxonomy | 174400000X Specialist |
| Additional Taxonomies | 207Q00000X Family Medicine |
| 261Q00000X | |
| Enumeration Date | 2023-10-30 |
| Last Update Date | 2023-10-30 |