| NPI | 1538988480 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ANJHARI MATTHEWS Owner 123-456-7890 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family |
| Additional Taxonomies | 261QP2300X Clinic/Center, Primary Care |
| Enumeration Date | 2024-10-08 |
| Last Update Date | 2024-10-31 |