| NPI | 1609597152 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MARLON C SALAMAT Officer 747-300-7541 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363LP2300X Nurse Practitioner, Primary Care |
| Additional Taxonomies | 261QP2300X Clinic/Center, Primary Care |
| Enumeration Date | 2022-09-02 |
| Last Update Date | 2022-09-09 |