| NPI | 1386072429 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KASIANI GOUNTOUMAS Nurse Practitioner 310-648-4802 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: CA 15137) |
| Enumeration Date | 2013-10-29 |
| Last Update Date | 2013-10-29 |