| NPI | 1811862790 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | BOONE GOODGAME Owner 737-337-5484 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207RH0000X Internal Medicine, Hematology |
| Additional Taxonomies | 207RH0003X Internal Medicine, Hematology & Oncology |
| Enumeration Date | 2025-10-09 |
| Last Update Date | 2025-11-21 |