| NPI | 1134354541 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TENNA K BEHM Officer 469-401-2386 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner |
| Additional Taxonomies | 207P00000X Emergency Medicine |
| 363A00000X Physician Assistant | |
| Enumeration Date | 2009-05-29 |
| Last Update Date | 2017-12-14 |