| NPI | 1982095972 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | WENDY C LU Credentialing Coordinator 904-221-2535 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207RN0300X Internal Medicine, Nephrology (Licence: FL ME112969) |
| Enumeration Date | 2015-02-11 |
| Last Update Date | 2015-02-11 |