| NPI | 1073205456 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | NGOZI MAUREEN NWANI Manager/Registered Agent 940-312-8036 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family |
| Enumeration Date | 2023-05-23 |
| Last Update Date | 2024-09-24 |