| NPI | 1609496512 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ELAINE VERONICA CANDELORO Owner, Provider 940-218-8506 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family |
| Enumeration Date | 2020-04-21 |
| Last Update Date | 2020-04-21 |