| NPI | 1144905852 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | GRACE KIM Psychiatric Nurse Practitioner 855-387-4378 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health |
| Enumeration Date | 2023-06-20 |
| Last Update Date | 2023-06-20 |