| NPI | 1386220382 |
|---|---|
| Doing Business As | INNOVAFUSION |
| Entity Type | Organization |
| Authorized Contact | GISELLE B. WIRLEN Nurse Practitioner 469-756-1711 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 261QP2300X Clinic/Center, Primary Care |
| Additional Taxonomies | 207Q00000X Family Medicine |
| 2083B0002X Preventive Medicine, Obesity Medicine | |
| Enumeration Date | 2021-03-20 |
| Last Update Date | 2022-12-08 |