| NPI | 1316685365 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JAIME CUNNINGHAM Owner 804-445-9565 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner |
| Additional Taxonomies | 207P00000X Emergency Medicine |
| Enumeration Date | 2022-05-20 |
| Last Update Date | 2022-05-20 |