NPI | 1407042807 |
---|---|
Entity Type | Organization |
Authorized Contact | PATRICIA CONCEICAO Office Manager 386-418-1234 |
Organization Subpart ? | No |
Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: FL 1557262) |
Enumeration Date | 2007-09-19 |
Last Update Date | 2007-09-27 |