| NPI | 1659094720 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CAROL U KALU Owner Of Entity 682-297-4097 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family |
| Additional Taxonomies | 363LP2300X Nurse Practitioner, Primary Care |
| Enumeration Date | 2022-09-22 |
| Last Update Date | 2022-09-22 |