| NPI | 1841528577 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | STEPHANUS J SERFONTEIN Sole Proprietor 304-675-6835 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: WV 21778) |
| Enumeration Date | 2009-11-18 |
| Last Update Date | 2011-03-16 |