NPI | 1154819977 |
---|---|
Professional Name | JOHANESE SANDY |
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: MD R183268) |
Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: MD R183268) |
Enumeration Date | 2018-04-26 |
Last Update Date | 2024-12-05 |