| NPI | 1598950396 |
|---|---|
| Former Name | OCTAVIA MANUEL |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: WI 7674-33) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: WI 141851-030) |
| 363L00000X Nurse Practitioner (Licence: WI 7674-33) | |
| Enumeration Date | 2007-09-14 |
| Last Update Date | 2024-01-31 |