NPI | 1316455231 |
---|---|
Entity Type | Organization |
Authorized Contact | LISA ROBERTSON Nurse Practitioner 803-474-5140 |
Organization Subpart ? | No |
Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: SC 20218) |
Enumeration Date | 2018-01-12 |
Last Update Date | 2018-06-16 |