NPI | 1508554320 |
---|---|
Doing Business As | FLAWLESS ICON DAVIE |
Entity Type | Organization |
Authorized Contact | VANESSA RUSSELL CEO 954-736-9744 |
Organization Subpart ? | No |
Primary Taxonomy | 363LF0000X Nurse Practitioner, Family |
Enumeration Date | 2023-04-28 |
Last Update Date | 2023-05-10 |