NPI | 1821354721 |
---|---|
Entity Type | Organization |
Authorized Contact | VICTOR MANUEL RIVERA Medical Director 939-644-7043 |
Organization Subpart ? | No |
Primary Taxonomy | 208D00000X General Practice (Licence: PR 17467) |
Additional Taxonomies | 133V00000X Dietitian, Registered (Licence: PR 1429) |
Enumeration Date | 2012-04-04 |
Last Update Date | 2012-04-04 |