| NPI | 1881203453 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | PHILLIP NYE Owner 772-584-0843 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207RS0012X Internal Medicine, Sleep Medicine |
| Additional Taxonomies | 207L00000X Anesthesiology |
| 207Q00000X Family Medicine | |
| Enumeration Date | 2020-07-29 |
| Last Update Date | 2023-11-14 |