| NPI | 1619663382 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MISPA NKONGHO Authorized Official 214-900-2529 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health |
| Enumeration Date | 2023-04-14 |
| Last Update Date | 2023-10-17 |