| NPI | 1245559145 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ANNIE REBECCA GIBSON Family Nurse Practitioner 267-979-0995 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261Q00000X (Licence: MD R164959) |
| Enumeration Date | 2010-05-18 |
| Last Update Date | 2010-05-18 |