| NPI | 1811723687 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MONICA SAM Provider/Owner 302-345-1188 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner |
| Additional Taxonomies | 207Q00000X Family Medicine |
| 363LF0000X Nurse Practitioner, Family | |
| 363LP0808X Nurse Practitioner, Psych/Mental Health | |
| 363LP2300X Nurse Practitioner, Primary Care | |
| 363LX0106X Nurse Practitioner, Occupational Health | |
| Enumeration Date | 2024-09-10 |
| Last Update Date | 2024-09-10 |