| NPI | 1962926659 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | PIERRE ANDRES PUENTE President 877-585-2955 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: FL ME93560) |
| Additional Taxonomies | 261QP2300X Clinic/Center Primary Care |
| Enumeration Date | 2017-08-03 |
| Last Update Date | 2018-03-17 |