| NPI | 1780126664 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | WENDY C LU Credentialing Coordinator 904-221-2535 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: FL ME104865) |
| Enumeration Date | 2016-11-09 |
| Last Update Date | 2016-11-09 |