| NPI | 1205595378 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | GINA VARGAS Owner 479-769-2519 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine |
| Additional Taxonomies | 261Q00000X |
| Enumeration Date | 2021-12-15 |
| Last Update Date | 2021-12-15 |