| NPI | 1861794042 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | BRETT BAKER Physician/President 843-534-1770 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363AM0700X Physician Assistant, Medical (Licence: SC TL1599) |
| Enumeration Date | 2010-11-22 |
| Last Update Date | 2020-02-21 |