| NPI | 1255162566 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JULIE DOMINGUEZ President 833-644-8244 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207RN0300X Internal Medicine, Nephrology |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family |
| Enumeration Date | 2024-08-08 |
| Last Update Date | 2024-12-02 |