| NPI | 1801263983 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JULIA BERESFORD Secretary 340-642-3813 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: FL ACN415) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: FL 94636) |
| Enumeration Date | 2015-08-25 |
| Last Update Date | 2016-02-22 |