| NPI | 1881932721 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | EDWIN HOMANKSY Owner 469-401-2386 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine |
| Additional Taxonomies | 363L00000X Nurse Practitioner |
| Enumeration Date | 2013-01-28 |
| Last Update Date | 2017-07-10 |