NPI | 1548393119 |
---|---|
Entity Type | Organization |
Authorized Contact | MICHELE R BROAD Owner 951-304-3180 |
Organization Subpart ? | No |
Primary Taxonomy | 363LA2200X Nurse Practitioner, Adult Health (Licence: CA 428809) |
Additional Taxonomies | 363LW0102X Nurse Practitioner, Women's Health (Licence: CA 428809) |
Enumeration Date | 2007-03-13 |
Last Update Date | 2015-12-15 |