| NPI | 1518748524 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | EBONIQUE THOMSON Owner/ Family Nurse Practitioner 520-510-0182 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QP2300X Clinic/Center, Primary Care |
| Enumeration Date | 2023-10-06 |
| Last Update Date | 2023-10-06 |