| NPI | 1568889947 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | PASCALE KIDANE Owner 954-336-0687 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: FL 9178816) |
| Enumeration Date | 2014-03-24 |
| Last Update Date | 2014-03-24 |