| NPI | 1801253323 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JEFF SOUZA President 916-436-3015 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner |
| Additional Taxonomies | 332B00000X Durable Medical Equipment & Medical Supplies |
| Enumeration Date | 2016-01-28 |
| Last Update Date | 2025-04-15 |