| NPI | 1942691878 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | WANDA ARISTORENAS Family Nurse Practitioner 731-607-4593 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QR1300X Clinic/Center, Rural Health |
| Additional Taxonomies | 207Q00000X Family Medicine |
| 208600000X Surgery | |
| Enumeration Date | 2015-02-13 |
| Last Update Date | 2022-09-06 |