| NPI | 1447137575 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | GLYKA MANAHAN Owner 888-292-8885 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine |
| Additional Taxonomies | 363L00000X Nurse Practitioner |
| Enumeration Date | 2025-08-20 |
| Last Update Date | 2025-08-20 |