| NPI | 1447501184 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | GERAME T WELLS Sole Member 270-887-0278 |
| Organization Subpart ? | No |
| Primary Taxonomy | 208600000X Surgery |
| Additional Taxonomies | 363L00000X Nurse Practitioner |
| Enumeration Date | 2012-09-20 |
| Last Update Date | 2014-04-11 |