| NPI | 1164017752 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | WINTER MELVIN Owner/Operator 757-904-3319 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family |
| Additional Taxonomies | 363LP2300X Nurse Practitioner, Primary Care |
| Enumeration Date | 2021-03-04 |
| Last Update Date | 2023-05-25 |