| NPI | 1992167910 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | THOMAS A KNIGGE COO 305-492-9170 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: FL ME69741) |
| Additional Taxonomies | 122300000X Dentist |
| 208000000X Pediatrics (Licence: FL ME125615) | |
| Enumeration Date | 2016-03-28 |
| Last Update Date | 2016-03-28 |