| NPI | 1376386813 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JOSEPH HERSKOVIC Np 347-370-2490 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family |
| Additional Taxonomies | 174400000X Specialist |
| Enumeration Date | 2024-06-13 |
| Last Update Date | 2024-06-13 |