| NPI | 1861973711 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ALICIA GONZALES-LONGORIA Owner 308-633-6202 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: NE 111555) |
| Enumeration Date | 2018-08-28 |
| Last Update Date | 2018-11-08 |