| NPI | 1962384669 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LISA KRUEGER VP Of Rcm And Contracting 888-408-7008 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207RG0300X Internal Medicine, Geriatric Medicine |
| Enumeration Date | 2025-07-23 |
| Last Update Date | 2025-07-30 |