| NPI | 1841674306 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MILTON SHAW Manager 210-341-5596 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207QA0505X Family Medicine, Adult Medicine |
| Additional Taxonomies | 363LA2200X Nurse Practitioner, Adult Health |
| 332B00000X Durable Medical Equipment & Medical Supplies | |
| Enumeration Date | 2015-07-15 |
| Last Update Date | 2016-05-24 |