| NPI | 1538980248 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MUHAMMAD USAMA JAMIL Director Billing 307-241-6004 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363LA2200X Nurse Practitioner Adult Health |
| Enumeration Date | 2024-10-24 |
| Last Update Date | 2024-10-24 |