| NPI | 1386309607 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | VISHNU UPADHYAY Owner 469-363-1940 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner Family |
| Additional Taxonomies | 261Q00000X Clinic/Center |
| 363LP0808X Nurse Practitioner Psychiatric/Mental Health | |
| Enumeration Date | 2021-11-02 |
| Last Update Date | 2024-08-29 |