| NPI | 1891745378 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ERIC GREGORY HALL Physician/Owner 772-287-2448 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: FL ME0052912) |
| Additional Taxonomies | 174400000X Specialist (Licence: FL ME0052912) |
| Enumeration Date | 2006-05-12 |
| Last Update Date | 2010-12-29 |