| NPI | 1205088838 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | STEPHANIE VANZEE Credentialing Coordinator 469-401-8820 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207RG0300X Internal Medicine, Geriatric Medicine (Licence: NV 6596) |
| Additional Taxonomies | 207RG0300X Internal Medicine, Geriatric Medicine (Licence: NV 9713) |
| Enumeration Date | 2008-10-14 |
| Last Update Date | 2025-04-01 |