NPI | 1952051963 |
---|---|
Entity Type | Organization |
Authorized Contact | MEGAN ALEXANDRIA WOLFF Provider 803-638-8628 |
Organization Subpart ? | No |
Primary Taxonomy | 363LF0000X Nurse Practitioner, Family |
Additional Taxonomies | 207R00000X Internal Medicine |
208000000X Pediatrics | |
261QP2300X Clinic/Center, Primary Care | |
Enumeration Date | 2022-03-24 |
Last Update Date | 2023-01-05 |