| NPI | 1679869408 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MIKE DIAZ Member 901-373-3300 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363LA2100X Nurse Practitioner, Acute Care (Licence: TN apn12232) |
| Enumeration Date | 2011-06-20 |
| Last Update Date | 2020-04-20 |