| NPI | 1205655602 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JOSHUA WILLIAM LAIRD-WILSON Owner 916-426-3016 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family |
| Additional Taxonomies | 207R00000X Internal Medicine |
| 207Q00000X Family Medicine | |
| Enumeration Date | 2024-10-03 |
| Last Update Date | 2025-12-03 |