| NPI | 1285461673 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SORAYA MICHELLE ST. LOUIS-AUGUSTIN Owner 862-219-3218 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363LP2300X Nurse Practitioner, Primary Care |
| Enumeration Date | 2024-09-18 |
| Last Update Date | 2024-09-18 |