| NPI | 1922639897 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TEMPLE MEWSHAW Owner 854-201-3636 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207RE0101X Internal Medicine, Endocrinology, Diabetes & Metabolism |
| Enumeration Date | 2020-01-30 |
| Last Update Date | 2022-01-21 |