| NPI | 1225417595 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JEAN FOLARIN Manager 210-410-4995 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: AZ AP4389) |
| Enumeration Date | 2015-05-20 |
| Last Update Date | 2015-05-20 |