| NPI | 1184067084 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MONNICA REYES Owner 251-591-8688 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: MS R852805) |
| Enumeration Date | 2013-04-10 |
| Last Update Date | 2013-04-10 |