| NPI | 1659109643 |
|---|---|
| Former Name | KIM MOON JA JACOBY HORNLEIN |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 163WA0400X Registered Nurse Addiction (Substance Use Disorder) (Licence: NY 467366-01) |
| Enumeration Date | 2024-07-23 |
| Last Update Date | 2024-08-08 |