| NPI | 1023993003 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DENIS GRIGOROV Nurse Practitioner 469-396-3369 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health |
| Enumeration Date | 2025-08-08 |
| Last Update Date | 2025-10-24 |