| 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 | 2023-05-17 |