NPI | 1609574029 |
---|---|
Entity Type | Organization |
Authorized Contact | JAMES O'HARA Owner 618-518-0872 |
Organization Subpart ? | No |
Primary Taxonomy | 363L00000X Nurse Practitioner |
Additional Taxonomies | 363LF0000X Nurse Practitioner, Family |
Enumeration Date | 2023-02-16 |
Last Update Date | 2023-02-16 |