| NPI | 1609620202 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JACQUELINE RUTINWA Pmhnp 857-237-5816 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363LP0808X Nurse Practitioner Psychiatric/Mental Health |
| Enumeration Date | 2024-04-11 |
| Last Update Date | 2024-04-11 |