| NPI | 1740765957 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SHAUKAT ALI Member 270-538-5880 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207RN0300X Internal Medicine, Nephrology |
| Additional Taxonomies | 363L00000X Nurse Practitioner |
| 364SA2200X Clinical Nurse Specialist, Adult Health | |
| Enumeration Date | 2018-10-03 |
| Last Update Date | 2023-12-08 |