| NPI | 1952738049 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LORETTA JENNINGS Executive Director 386-255-5569 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207RI0200X Internal Medicine, Infectious Disease (Licence: FL 12473) |
| Enumeration Date | 2013-10-03 |
| Last Update Date | 2014-02-20 |