| NPI | 1407452006 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | VIDA SARKODIE Nurse Practitioner 862-596-0705 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health |
| Additional Taxonomies | 363LA2200X Nurse Practitioner, Adult Health |
| 364SA2200X Clinical Nurse Specialist, Adult Health | |
| Enumeration Date | 2020-12-08 |
| Last Update Date | 2020-12-08 |