| NPI | 1285449660 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | IBONNE LOPEZ MASO Owner 682-707-5982 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family |
| Enumeration Date | 2025-02-11 |
| Last Update Date | 2025-04-07 |