| NPI | 1932412640 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JODI BUCHHOLZ Biller 850-640-0081 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: FL 9166254) |
| Enumeration Date | 2010-07-22 |
| Last Update Date | 2010-07-22 |