| NPI | 1588224836 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MARIA V EDQUILANG President 346-240-0979 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363LG0600X Nurse Practitioner, Gerontology |
| Additional Taxonomies | 363L00000X Nurse Practitioner |
| 363LA2200X Nurse Practitioner, Adult Health | |
| Enumeration Date | 2019-06-19 |
| Last Update Date | 2019-06-19 |