NPI | 1538782826 |
---|---|
Former Name | JESSICA KURZDORFER |
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: NY 402976) |
Additional Taxonomies | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: NM 70145) |
363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: OR 10012124) | |
363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: MD R268663) | |
Enumeration Date | 2020-05-21 |
Last Update Date | 2024-10-03 |