| NPI | 1629897236 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LINDSEY KAY FARRAR FOREMAN Nurse Practitioner 209-403-3063 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family |
| Enumeration Date | 2024-10-09 |
| Last Update Date | 2024-11-03 |