| NPI | 1952282188 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JAI BRAMBHATT Credentialing Specalist 904-730-1585 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner |
| Additional Taxonomies | 363LP0808X Nurse Practitioner, Psych/Mental Health |
| Enumeration Date | 2025-09-12 |
| Last Update Date | 2025-09-12 |