| NPI | 1982450789 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | NOAH HERBERT President 386-271-0050 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family |
| Enumeration Date | 2024-04-24 |
| Last Update Date | 2024-05-22 |