| NPI | 1508358854 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | REWA A BANK Owner 429-222-9828 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: OH CNP019414) |
| Enumeration Date | 2018-06-02 |
| Last Update Date | 2018-06-02 |