| NPI | 1508461252 |
|---|---|
| Other Name | SELF |
| Entity Type | Organization |
| Authorized Contact | BEENA K BIJOY A RN P., Fnp Bc 754-246-8414 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family |
| Enumeration Date | 2020-12-01 |
| Last Update Date | 2020-12-01 |