| NPI | 1851879910 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LYNN WITT National Director 386-697-3793 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207RC0000X Internal Medicine Cardiovascular Disease (Licence: FL ME104128) |
| Additional Taxonomies | 207RC0000X Internal Medicine Cardiovascular Disease |
| Enumeration Date | 2018-08-01 |
| Last Update Date | 2022-08-10 |