| NPI | 1194282285 |
|---|---|
| Other Name | UNCP STUDENT BLUE GROUP |
| Entity Type | Organization |
| Authorized Contact | MOUZON BASS Administrator 972-367-4845 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner |
| Enumeration Date | 2019-02-25 |
| Last Update Date | 2019-02-25 |