| NPI | 1073218913 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DANIEL BAKER President 888-964-6681 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family |
| Enumeration Date | 2023-03-31 |
| Last Update Date | 2023-03-31 |