NPI | 1528330842 |
---|---|
Entity Type | Organization |
Authorized Contact | ZACHARY CROSEN Office Manager 256-454-2508 |
Organization Subpart ? | No |
Primary Taxonomy | 363LA2200X Nurse Practitioner, Adult Health (Licence: AL 1-105028) |
Enumeration Date | 2012-02-01 |
Last Update Date | 2024-05-30 |