| NPI | 1467964767 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MELANIE J WILSON Owner 210-245-6436 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363LA2100X Nurse Practitioner Acute Care |
| Additional Taxonomies | 332B00000X Durable Medical Equipment & Medical Supplies |
| Enumeration Date | 2017-10-26 |
| Last Update Date | 2021-01-14 |