| NPI | 1780447581 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JUVEL-LOU VELASCO Np 520-878-8233 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner |
| Additional Taxonomies | 261Q00000X |
| Enumeration Date | 2024-02-05 |
| Last Update Date | 2024-07-09 |