| NPI | 1811358567 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | PATRICIA SUTHERLAND Provider Enrollment 229-891-9131 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207RH0003X Internal Medicine, Hematology & Oncology |
| Enumeration Date | 2016-03-09 |
| Last Update Date | 2023-07-28 |