| NPI | 1801363213 |
|---|---|
| Former Name | VIVIAN TANTOH MONDO |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: TX 929987) |
| Enumeration Date | 2018-10-24 |
| Last Update Date | 2024-04-17 |