| NPI | 1598884561 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | IRIS STACKER CEO 662-378-3783 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 363L00000X Nurse Practitioner |
| Additional Taxonomies | 207W00000X Ophthalmology |
| Enumeration Date | 2007-03-28 |
| Last Update Date | 2022-11-14 |