| NPI | 1194239327 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MARIE ROSE SAMUELA JASMIN Sole Member 754-214-9598 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: FL 9294753) |
| Enumeration Date | 2017-11-27 |
| Last Update Date | 2022-09-29 |