| NPI | 1265288658 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DERICK YENSILA NGORAN Pmhnp Bc 701-610-1994 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363LP0808X Nurse Practitioner Psychiatric/Mental Health |
| Enumeration Date | 2024-04-25 |
| Last Update Date | 2024-04-25 |