| NPI | 1073989208 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DEANNA LYNN KUDULIS Nurse Practioner 661-729-8655 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: CA 15849) |
| Enumeration Date | 2015-08-11 |
| Last Update Date | 2015-08-11 |