| NPI | 1912288770 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | RANDALL J TWENHAFEL Chairman, CEO, President 907-644-3011 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363LP0200X Nurse Practitioner, Pediatrics (Licence: AK 1145) |
| Enumeration Date | 2011-09-06 |
| Last Update Date | 2011-09-06 |