| NPI | 1750867297 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LESLIE S LONG Authorized Official 803-254-2394 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology |
| Additional Taxonomies | 207LC0200X Anesthesiology Critical Care Medicine |
| 207LP2900X Anesthesiology Pain Medicine | |
| Enumeration Date | 2018-07-18 |
| Last Update Date | 2018-07-18 |