NPI | 1497328777 |
---|---|
Entity Type | Organization |
Authorized Contact | MATTHEW ROBERSON Cmo 210-364-8636 |
Organization Subpart ? | No |
Primary Taxonomy | 207Q00000X Family Medicine |
Additional Taxonomies | 363LF0000X Nurse Practitioner, Family |
363LP0808X Nurse Practitioner, Psych/Mental Health | |
Enumeration Date | 2021-07-23 |
Last Update Date | 2021-08-09 |