| NPI | 1952278749 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JAN RYSZKOWSKI Incorporator/Organizer 501-352-7043 |
| Organization Subpart ? | No |
| Primary Taxonomy | 208D00000X General Practice |
| Additional Taxonomies | 163WW0000X Registered Nurse, Wound Care |
| 207U00000X Nuclear Medicine | |
| Enumeration Date | 2025-10-17 |
| Last Update Date | 2025-11-24 |