| NPI | 1790122034 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SANDY WALDRON Credentialing Contact 561-300-6909 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207RA0401X Internal Medicine, Addiction Medicine |
| Enumeration Date | 2013-05-28 |
| Last Update Date | 2016-01-14 |