| NPI | 1346725488 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JOSHUA HARRISON Owner 888-662-3376 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207N00000X Dermatology |
| Additional Taxonomies | 363L00000X Nurse Practitioner |
| 363LA2200X Nurse Practitioner, Adult Health | |
| 363LG0600X Nurse Practitioner, Gerontology | |
| 363LP2300X Nurse Practitioner, Primary Care | |
| Enumeration Date | 2018-09-25 |
| Last Update Date | 2024-08-29 |