| NPI | 1659126357 |
|---|---|
| Doing Business As | GOLDEN CROWN |
| Entity Type | Organization |
| Authorized Contact | TONIKA LUDELL LAFLORA Owner/Provider 469-469-5458 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363LP2300X Nurse Practitioner, Primary Care |
| Enumeration Date | 2024-04-17 |
| Last Update Date | 2024-04-17 |