NPI | 1902160211 |
---|---|
Entity Type | Organization |
Authorized Contact | EDEN E VILLA Physician/Director 671-647-4533 |
Organization Subpart ? | No |
Primary Taxonomy | 207R00000X Internal Medicine (Licence: GU M1705) |
Additional Taxonomies | 261QH0100X Clinic/Center, Health Services (Licence: GU M-1705) |
Enumeration Date | 2012-07-02 |
Last Update Date | 2014-04-10 |