| NPI | 1376031500 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | NORA OVALLE-RENDON Executive Assistant 210-734-1010 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 363LG0600X Nurse Practitioner, Gerontology |
| Enumeration Date | 2018-04-24 |
| Last Update Date | 2018-04-24 |