| NPI | 1760661938 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | NATALIA A SHIRIAEVA President 904-964-1888 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: FL ME0081878) |
| Enumeration Date | 2007-10-24 |
| Last Update Date | 2007-10-24 |