| NPI | 1710654900 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MONNIE E ADERETI CEO 469-756-7021 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family |
| Additional Taxonomies | 251S00000X |
| Enumeration Date | 2021-08-25 |
| Last Update Date | 2021-12-28 |