NPI | 1255879060 |
---|---|
Entity Type | Organization |
Authorized Contact | RICHARD STERNE Owner 754-234-0155 |
Organization Subpart ? | No |
Primary Taxonomy | 207Q00000X Family Medicine (Licence: FL OS5102) |
Additional Taxonomies | 2084A0401X Psychiatry & Neurology, Addiction Medicine (Licence: FL ME47100) |
363LF0000X Nurse Practitioner, Family (Licence: FL ARNP9299227) | |
Enumeration Date | 2017-02-01 |
Last Update Date | 2017-09-19 |