| NPI | 1699655316 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | NADEGE TAN Managing Member 857-246-9393 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261Q00000X Clinic/Center |
| Additional Taxonomies | 363LA2200X Nurse Practitioner, Adult Health |
| Enumeration Date | 2025-09-04 |
| Last Update Date | 2025-11-13 |