NPI | 1174309819 |
---|---|
Doing Business As | DELTA PHOENIX FAMILY AND AESTHETIC MEDICINE |
Entity Type | Organization |
Authorized Contact | MONICA JOY STANFORD Owner Sole Proprietor 662-231-8436 |
Organization Subpart ? | No |
Primary Taxonomy | 363LF0000X Nurse Practitioner, Family |
Enumeration Date | 2023-09-07 |
Last Update Date | 2023-11-07 |