| NPI | 1063240117 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SOONDY R JEGEDE Psychiatric Nurse Practitioner 386-235-0348 |
| Organization Subpart ? | No |
| Primary Taxonomy | 2084P0800X Psychiatry & Neurology, Psychiatry |
| Enumeration Date | 2024-07-22 |
| Last Update Date | 2024-07-26 |