| NPI | 1871243113 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | IRENE KAMAU Np 678-707-3234 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363LA2200X Nurse Practitioner Adult Health |
| Additional Taxonomies | 363L00000X Nurse Practitioner |
| Enumeration Date | 2022-03-28 |
| Last Update Date | 2022-03-28 |