| NPI | 1811154354 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TARA KOWALSKI Credentialing Manager 888-220-6432 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207RI0200X Internal Medicine, Infectious Disease (Licence: IL 00009202) |
| Enumeration Date | 2008-05-21 |
| Last Update Date | 2013-12-13 |