| NPI | 1790015923 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LISHA FALK VP Of Contracting 800-893-9698 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine |
| Additional Taxonomies | 363AM0700X Physician Assistant Medical |
| 363L00000X Nurse Practitioner | |
| Enumeration Date | 2010-01-11 |
| Last Update Date | 2016-01-11 |