| NPI | 1568959807 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MOHAMED COULIBALY DIT FALL Sole Mbr/Owner 520-256-7028 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: AZ AP5641) |
| Enumeration Date | 2018-04-20 |
| Last Update Date | 2018-06-25 |