| NPI | 1922426402 | 
|---|---|
| Entity Type | Organization | 
| Authorized Contact | THERESA ANNE PINDER Sole Member, CEO 772-215-9946  | 
| Organization Subpart ? | No | 
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: FL 1476272)  | 
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: FL ME69414)  | 
| Enumeration Date | 2014-04-02 | 
| Last Update Date | 2024-07-19 |