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 |