| NPI | 1821797622 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KIM LILLY THOMSON Authorized Rep /Nurse Practitioner 941-298-0045 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363LA2200X Nurse Practitioner, Adult Health |
| Additional Taxonomies | 207Q00000X Family Medicine |
| Enumeration Date | 2023-03-01 |
| Last Update Date | 2024-10-14 |