NPI | 1578004453 |
---|---|
Entity Type | Organization |
Authorized Contact | ELIE E. HAGE-KORBAN President 731-512-0104 |
Organization Subpart ? | No |
Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: TN APN0000022418) |
Enumeration Date | 2017-03-13 |
Last Update Date | 2017-03-13 |