| NPI | 1033085402 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | NATHAN GARCIA Project Lead 463-273-1569 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner |
| Additional Taxonomies | 363A00000X Physician Assistant |
| Enumeration Date | 2025-10-14 |
| Last Update Date | 2025-10-14 |