| NPI | 1710715800 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | FORREST WATSON CEO 302-407-5316 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 2083P0901X Preventive Medicine Public Health & General Preventive Medicine |
| Additional Taxonomies | 101Y00000X Counselor |
| 207Q00000X Family Medicine | |
| 363LF0000X Nurse Practitioner Family | |
| 363LP0200X Nurse Practitioner Pediatrics | |
| Enumeration Date | 2024-07-22 |
| Last Update Date | 2024-07-22 |