| NPI | 1942552732 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DAN ELLIS President 601-636-0097 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363LG0600X Nurse Practitioner, Gerontology (Licence: MS R826981) |
| Enumeration Date | 2012-10-04 |
| Last Update Date | 2012-12-26 |