| NPI | 1104682509 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | PAUL MENSAH Primary Health Care Provider 267-449-9387 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363LG0600X Nurse Practitioner, Gerontology |
| Additional Taxonomies | 207QG0300X Family Medicine, Geriatric Medicine |
| 261QP2300X Clinic/Center, Primary Care | |
| Enumeration Date | 2024-02-23 |
| Last Update Date | 2024-03-23 |