| NPI | 1083078612 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | AMBER MANNING Owner 302-803-2797 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: DE LG-0000643) |
| Additional Taxonomies | 261QP2300X Clinic/Center, Primary Care |
| Enumeration Date | 2016-04-10 |
| Last Update Date | 2019-06-11 |