| NPI | 1770199341 |
|---|---|
| Former Name | NICOLE MINIUM |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LP0808X Nurse Practitioner Psychiatric/Mental Health (Licence: PA SP022542) |
| Enumeration Date | 2020-09-19 |
| Last Update Date | 2020-12-31 |