| NPI | 1851155758 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JANINE DUKUZE Nurse Practitioner 682-201-8000 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family |
| Enumeration Date | 2024-02-12 |
| Last Update Date | 2024-02-12 |