| NPI | 1942711064 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SANJAY DASS Owner 501-626-0053 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine |
| Additional Taxonomies | 363L00000X Nurse Practitioner |
| Enumeration Date | 2017-10-16 |
| Last Update Date | 2019-04-19 |