NPI | 1063524049 |
---|---|
Former Name | RAKIYA ENGO AKWA |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 261QM1300X Clinic/Center, Multi-Specialty (Licence: TX N4380) |
Additional Taxonomies | 261QU0200X Clinic/Center, Urgent Care (Licence: TX N4380) |
261QP2300X Clinic/Center, Primary Care (Licence: TX N4380) | |
Enumeration Date | 2006-08-31 |
Last Update Date | 2013-10-23 |