| NPI | 1861102998 |
|---|---|
| Doing Business As | MEDICAL PRACTICE |
| Entity Type | Organization |
| Authorized Contact | ARTHUR OLIVEROS President 331-269-9896 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family |
| Additional Taxonomies | 363L00000X Nurse Practitioner |
| 363LP2300X Nurse Practitioner, Primary Care | |
| Enumeration Date | 2022-11-30 |
| Last Update Date | 2023-09-26 |