NPI | 1578993267 |
---|---|
Entity Type | Organization |
Authorized Contact | DEONTRANESE TREVA TAYLOR Owner 601-754-0772 |
Organization Subpart ? | No |
Primary Taxonomy | 163WP0200X Registered Nurse, Pediatrics (Licence: MS R865884) |
Enumeration Date | 2013-11-18 |
Last Update Date | 2013-11-18 |