| NPI | 1073349387 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JOHN FRANCIS BIRD Practice Manager 239-298-6976 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health |
| Enumeration Date | 2024-09-12 |
| Last Update Date | 2024-09-12 |