| NPI | 1720112246 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | GAIL LONG Billing Manager 800-209-1410 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207RE0101X Internal Medicine, Endocrinology, Diabetes & Metabolism (Licence: CA G10128) |
| Enumeration Date | 2007-03-15 |
| Last Update Date | 2020-08-22 |