| NPI | 1740924265 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ANASTANSIA MONAYP RATEMO Managing Director 469-579-7020 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family |
| Enumeration Date | 2022-04-21 |
| Last Update Date | 2022-04-21 |