NPI | 1821987934 |
---|---|
Doing Business As | INITIA NOVA DELAWARE |
Entity Type | Organization |
Authorized Contact | JOHN WILLIAM DOUGHERTY Medical Director 302-256-0927 |
Organization Subpart ? | No |
Primary Taxonomy | 2084P0800X Psychiatry & Neurology, Psychiatry |
Enumeration Date | 2025-07-02 |
Last Update Date | 2025-07-02 |