| NPI | 1174304745 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CRYSTAL MARIE PERRY CEO/Nurse Practitioner 302-765-7109 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363LA2200X Nurse Practitioner, Adult Health |
| Additional Taxonomies | 261QP2300X Clinic/Center, Primary Care |
| Enumeration Date | 2023-10-10 |
| Last Update Date | 2024-01-25 |