| NPI | 1598346611 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JAMES STANGLE Np 623-401-5437 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363LP0200X Nurse Practitioner, Pediatrics |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family |
| Enumeration Date | 2021-04-20 |
| Last Update Date | 2021-04-28 |