| NPI | 1376274126 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KRISTI LEE Senior Director 844-969-0686 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine |
| Additional Taxonomies | 363A00000X Physician Assistant |
| 363L00000X Nurse Practitioner | |
| 207R00000X Internal Medicine | |
| Enumeration Date | 2022-06-22 |
| Last Update Date | 2022-06-22 |