| NPI | 1871292185 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ZUNILEY ABALLE-HERNANDEZ Authorized Official 800-230-0220 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family |
| Enumeration Date | 2023-02-24 |
| Last Update Date | 2025-03-19 |