| NPI | 1407403207 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LANE RICHARD SALAZAR Nurse Practitioner/Owner 479-461-8765 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363LG0600X Nurse Practitioner, Gerontology |
| Enumeration Date | 2019-08-26 |
| Last Update Date | 2019-09-07 |