| NPI | 1952057770 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DENNIS CHARLES KOUKOL President 253-279-3487 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207RC0000X Internal Medicine, Cardiovascular Disease |
| Enumeration Date | 2022-03-02 |
| Last Update Date | 2022-03-02 |