| NPI | 1821837238 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | IRENE KAKOURAS Resident 864-704-6029 |
| Organization Subpart ? | No |
| Primary Taxonomy | 390200000X Student in an Organized Health Care Education/Training Program |
| Enumeration Date | 2024-05-23 |
| Last Update Date | 2024-05-23 |