| NPI | 1164194601 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SARAH KIM Director 800-879-6137 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner |
| Additional Taxonomies | 261Q00000X Clinic/Center |
| 261QI0500X Clinic/Center, Infusion Therapy | |
| Enumeration Date | 2021-10-04 |
| Last Update Date | 2025-01-07 |