| NPI | 1003587361 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ALTIA A LANDIS Owner 888-701-4161 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family |
| Enumeration Date | 2021-09-25 |
| Last Update Date | 2024-08-05 |