NPI | 1548514482 |
---|---|
Entity Type | Organization |
Authorized Contact | NIKKI MIGLORE Owner 480-229-1986 |
Organization Subpart ? | No |
Primary Taxonomy | 363LA2200X Nurse Practitioner, Adult Health (Licence: IL 209008745) |
Enumeration Date | 2012-10-30 |
Last Update Date | 2012-10-30 |