| NPI | 1962247676 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | RICHARD FIDEL SEVILLA Nurse Practitioner 209-470-8575 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner |
| Additional Taxonomies | 251J00000X Nursing Care |
| Enumeration Date | 2024-06-26 |
| Last Update Date | 2024-06-26 |