| NPI | 1942448667 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | WILLIAM H. PETERS Master Administrator 601-264-8845 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207PE0005X Emergency Medicine, Undersea and Hyperbaric Medicine (Licence: MS 07762) |
| Enumeration Date | 2009-02-03 |
| Last Update Date | 2015-08-17 |