| NPI | 1952600546 |
|---|---|
| Doing Business As | SAME |
| Entity Type | Organization |
| Authorized Contact | GEORGE WILLIAM CHISHOLM Medical Doctor 407-841-1521 |
| Organization Subpart ? | No |
| Primary Taxonomy | 174400000X Specialist (Licence: FL FL-035767) |
| Enumeration Date | 2011-03-22 |
| Last Update Date | 2011-03-22 |