| NPI | 1659180891 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DUSTIN BRADFORD VON HOLTEN Pmhnp 347-573-9479 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health |
| Enumeration Date | 2025-01-02 |
| Last Update Date | 2025-01-02 |