| NPI | 1740219864 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | THOMAS J VAN ESS Administrator 906-225-4500 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine |
| Additional Taxonomies | 208000000X Pediatrics |
| Enumeration Date | 2006-07-01 |
| Last Update Date | 2020-08-22 |