| NPI | 1831529551 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | M. KATHERINE SORENSON Vice President, Practice Management 9259-522-8888 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine |
| Additional Taxonomies | 207Q00000X Family Medicine |
| 207RE0101X Internal Medicine, Endocrinology, Diabetes & Metabolism | |
| Enumeration Date | 2013-11-15 |
| Last Update Date | 2013-11-15 |