NPI | 1427367119 |
---|---|
Entity Type | Organization |
Authorized Contact | ANGELA DAWN LOVE Owner 772-766-5683 |
Organization Subpart ? | No |
Primary Taxonomy | 363LW0102X Nurse Practitioner, Women's Health (Licence: FL 3390252) |
Enumeration Date | 2010-09-29 |
Last Update Date | 2010-09-29 |