| NPI | 1306965348 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | AVA EAGLES Clinic Operations Mgr Co Owner 515-265-8200 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: IA A098023) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: IA 25966) |
| Enumeration Date | 2007-03-29 |
| Last Update Date | 2011-03-23 |