| NPI | 1982488664 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DEBORAH PINCINCE Administrator 866-389-2727 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine |
| Additional Taxonomies | 207R00000X Internal Medicine |
| 363LF0000X Nurse Practitioner, Family | |
| Enumeration Date | 2023-08-23 |
| Last Update Date | 2023-08-23 |