| NPI | 1265159073 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | OLAMIDE VINCENT Nurse Practitioner 484-340-9768 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health |
| Additional Taxonomies | 261QM0801X |
| Enumeration Date | 2022-10-24 |
| Last Update Date | 2022-10-25 |