| NPI | 1952980088 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | AMANDA VANDEN WYNBOOM Authorized Official 515-289-4549 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family |
| Enumeration Date | 2021-04-06 |
| Last Update Date | 2021-04-06 |