| NPI | 1730204918 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LESLEY M CLARK Office Manager 239-275-5934 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: FL ME78775) |
| Enumeration Date | 2007-03-20 |
| Last Update Date | 2010-06-25 |