| NPI | 1477069995 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MANOUCHCAR PIERRE-VAL Nurse Practitioner/ Co Owner 888-753-3824 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family |
| Additional Taxonomies | 363LP0808X Nurse Practitioner, Psych/Mental Health |
| Enumeration Date | 2017-12-20 |
| Last Update Date | 2018-08-04 |