| NPI | 1821195033 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | BRETT BRAUN Chief Operating Officer 888-452-4762 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 208D00000X General Practice (Licence: PA MD417193) |
| Additional Taxonomies | 204R00000X Electrodiagnostic Medicine (Licence: PA MD450924) |
| 207Y00000X Otolaryngology (Licence: PA MD450155) | |
| 208600000X Surgery (Licence: PA MD447392) | |
| 208600000X Surgery (Licence: PA MD446903) | |
| 208800000X Urology | |
| 208D00000X General Practice (Licence: PA MD037172L) | |
| 363LF0000X Nurse Practitioner Family (Licence: PA SP012816) | |
| Enumeration Date | 2006-09-20 |
| Last Update Date | 2019-03-20 |