| NPI | 1720651862 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | STEPHANIE D MARSHALL Owner 192-472-8990 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207RC0000X Internal Medicine, Cardiovascular Disease |
| Enumeration Date | 2021-07-16 |
| Last Update Date | 2024-02-27 |