| NPI | 1578387106 |
|---|---|
| Former Name | WELLINGTON JUDSON HUMES |
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: CA 95029934) |
| Enumeration Date | 2024-11-11 |
| Last Update Date | 2024-11-11 |