| NPI | 1932814787 |
|---|---|
| Former Name | NINA ROBERTA JOHNSON |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: MI 4704316882) |
| Enumeration Date | 2023-01-17 |
| Last Update Date | 2023-09-28 |