NPI | 1255815858 |
---|---|
Entity Type | Organization |
Authorized Contact | ANTHONY BALDWIN SYELLU MSOWOYA Co Owner Family Nurse Practitioner 602-741-0124 |
Organization Subpart ? | No |
Primary Taxonomy | 363LP2300X Nurse Practitioner, Primary Care |
Enumeration Date | 2018-09-19 |
Last Update Date | 2024-09-16 |