| NPI | 1669013553 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LIZA ANTON-VALDEZ Nurse Practitioner 910-724-0182 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363LA2200X Nurse Practitioner, Adult Health |
| Enumeration Date | 2019-10-02 |
| Last Update Date | 2023-09-21 |