| NPI | 1841657053 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MARTHA R KELSO Chief Regulatory Officer 888-256-3814 |
| Organization Subpart ? | No |
| Primary Taxonomy | 174400000X Specialist |
| Additional Taxonomies | 163WW0000X Registered Nurse, Wound Care |
| 207QG0300X Family Medicine, Geriatric Medicine | |
| Enumeration Date | 2016-01-19 |
| Last Update Date | 2025-05-13 |