| NPI | 1912382094 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ATIF BAWAHAB Admin 979-574-7109 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363LA2100X Nurse Practitioner, Acute Care (Licence: MI 4704257057) |
| Enumeration Date | 2015-07-30 |
| Last Update Date | 2015-07-30 |