| NPI | 1245802081 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CRYSTAL KIM Nurse Practitioner/Owner 347-855-4192 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health |
| Enumeration Date | 2021-07-12 |
| Last Update Date | 2021-07-12 |