| NPI | 1003352881 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | GITANA NG Nurse Practitioner 772-370-3211 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363LA2200X Nurse Practitioner, Adult Health (Licence: FL 2776282) |
| Additional Taxonomies | 363LA2200X Nurse Practitioner, Adult Health (Licence: FL 9213298) |
| 363LA2200X Nurse Practitioner, Adult Health (Licence: FL 9231419) | |
| Enumeration Date | 2017-01-17 |
| Last Update Date | 2017-01-17 |