NPI | 1093865933 |
---|---|
Entity Type | Organization |
Authorized Contact | DORIS MITCHELL Director 662-627-2741 |
Organization Subpart ? | No |
Primary Taxonomy | 363LP0200X Nurse Practitioner, Pediatrics (Licence: MS R125740) |
Enumeration Date | 2007-01-11 |
Last Update Date | 2020-08-22 |