| NPI | 1912033846 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MARY JO VOLLMER-SANDHOLM Pediatric Nurse Practitioner 909-558-8514 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363LP0200X Nurse Practitioner, Pediatrics (Licence: CA 533452) |
| Enumeration Date | 2007-02-26 |
| Last Update Date | 2020-08-22 |