| NPI | 1285155416 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LA WANDA ARNITA PULLEY V Ie President 954-683-1352 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: NC 5008462) |
| Enumeration Date | 2017-06-28 |
| Last Update Date | 2022-07-21 |