| NPI | 1750663191 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MATTHEW SCHUEREN V.P. Finance 888-562-5442 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine |
| Additional Taxonomies | 208000000X Pediatrics |
| Enumeration Date | 2011-09-12 |
| Last Update Date | 2017-12-06 |