| NPI | 1467142497 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TALIA SAN ROMAN Psychiatric Nurse Practitioner 833-695-4673 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health |
| Enumeration Date | 2023-05-12 |
| Last Update Date | 2023-05-12 |