| NPI | 1700135928 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DAILY V YBARGOLLIN Owner 305-123-4567 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: FL RN9214684) |
| Enumeration Date | 2012-09-04 |
| Last Update Date | 2012-09-04 |