| NPI | 1003427196 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MARYAM RAZA Owner 855-955-2256 |
| Organization Subpart ? | No |
| Primary Taxonomy | 2083P0011X Preventive Medicine, Undersea and Hyperbaric Medicine |
| Additional Taxonomies | 207R00000X Internal Medicine |
| 363LA2100X Nurse Practitioner, Acute Care | |
| 363LF0000X Nurse Practitioner, Family | |
| Enumeration Date | 2020-08-12 |
| Last Update Date | 2024-01-08 |