| NPI | 1770773590 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MICHAEL PIN Owner 888-745-2455 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207QA0505X Family Medicine, Adult Medicine (Licence: CA G45813) |
| Enumeration Date | 2007-07-27 |
| Last Update Date | 2007-07-27 |