| NPI | 1174343800 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | PAUL MAYOMBOLA Nurse Practitioner 214-554-1945 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363LA2200X Nurse Practitioner, Adult Health |
| Additional Taxonomies | 363LA2100X Nurse Practitioner, Acute Care |
| 363LG0600X Nurse Practitioner, Gerontology | |
| Enumeration Date | 2024-10-16 |
| Last Update Date | 2024-10-16 |