| NPI | 1982783619 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | REMILEKUN SUBEDAT ADESOJI Owner 662-536-2100 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: MS 16532) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: MS 16591) |
| Enumeration Date | 2006-11-03 |
| Last Update Date | 2010-11-04 |