| NPI | 1104693969 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MEGAN ELIZABETH MOHSIN Co Owner 386-344-1538 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family |
| 363LP0808X Nurse Practitioner, Psych/Mental Health | |
| Enumeration Date | 2023-12-11 |
| Last Update Date | 2024-10-14 |