| NPI | 1871471490 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | COLETTE WISEMAN President 424-234-6461 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine |
| Additional Taxonomies | 174N00000X Lactation Consultant, Non-RN |
| 207PE0004X Emergency Medicine, Emergency Medical Services | |
| Enumeration Date | 2025-08-22 |
| Last Update Date | 2025-08-22 |