| NPI | 1861266645 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SHELLY YVETTE ALASTI Nurse Practitioner 984-301-8178 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363LA2200X Nurse Practitioner, Adult Health |
| Enumeration Date | 2023-11-13 |
| Last Update Date | 2023-12-04 |