| NPI | 1013695741 |
|---|---|
| Former Name | SAMUEL HOGAN |
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: UT 10982541-4405) |
| Additional Taxonomies | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: UT 10982541-8900) |
| Enumeration Date | 2023-07-11 |
| Last Update Date | 2023-07-19 |