| NPI | 1437871761 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | HABTOM LEGESE TEWELDEBRAHAN Member And Manager 469-238-4774 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family |
| Enumeration Date | 2022-09-14 |
| Last Update Date | 2022-09-14 |