| NPI | 1003552159 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | OLUWATOSIN FANIMO Owner/Provider 202-246-3013 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health |
| Additional Taxonomies | 363L00000X Nurse Practitioner |
| Enumeration Date | 2022-05-11 |
| Last Update Date | 2022-05-11 |