| NPI | 1013565886 |
|---|---|
| Former Name | OLUWASEUN TITILOPE OMODARA |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: NJ 26NJ00948800) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: NY F344464-1) |
| Enumeration Date | 2019-08-26 |
| Last Update Date | 2019-08-26 |