| NPI | 1881042828 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | BRIAN CROMER Manager 806-800-3376 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: NH 05812823) |
| Enumeration Date | 2016-06-01 |
| Last Update Date | 2016-06-01 |