| NPI | 1023358454 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KEITH ALLEN WICHINSKI President 210-995-3681 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: TX 612139) |
| Enumeration Date | 2013-02-21 |
| Last Update Date | 2013-05-03 |