| NPI | 1144937632 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ROLAND TSOPZE Owner Of Entity 469-546-5539 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health |
| Enumeration Date | 2022-11-03 |
| Last Update Date | 2022-11-17 |