| NPI | 1780299081 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ODILIA S KWATENG Fnp 623-385-2064 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner Family |
| Additional Taxonomies | 363LP0808X Nurse Practitioner Psychiatric/Mental Health |
| Enumeration Date | 2020-09-14 |
| Last Update Date | 2024-08-08 |