| NPI | 1780121277 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | STACEY SANTIAGO Owner 256-508-9034 |
| Organization Subpart ? | No |
| Primary Taxonomy | 171W00000X Contractor (Licence: FL ARNP9224482) |
| Additional Taxonomies | 363LX0106X Nurse Practitioner Occupational Health (Licence: MD R185090) |
| Enumeration Date | 2017-01-23 |
| Last Update Date | 2020-07-21 |