| NPI | 1235917907 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | BARNETTE BENOIT Manager/Provider 754-242-2807 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363LP2300X Nurse Practitioner, Primary Care |
| Additional Taxonomies | 261QH0100X Clinic/Center, Health Services |
| Enumeration Date | 2023-09-14 |
| Last Update Date | 2023-09-14 |