NPI | 1679187140 |
---|---|
Entity Type | Organization |
Authorized Contact | RONALD P LINDAHL COO 833-765-3648 |
Organization Subpart ? | No |
Primary Taxonomy | 261QM2500X Clinic/Center, Medical Specialty |
Additional Taxonomies | 261QI0500X Clinic/Center, Infusion Therapy |
363L00000X Nurse Practitioner | |
Enumeration Date | 2020-09-02 |
Last Update Date | 2022-09-27 |