NPI | 1144458183 |
---|---|
Entity Type | Organization |
Authorized Contact | ADEDAPO MOFOLUS ODUWOLE Owner 843-449-2576 |
Organization Subpart ? | No |
Primary Taxonomy | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: SC 31507) |
Additional Taxonomies | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: WI 43425) |
Enumeration Date | 2009-06-29 |
Last Update Date | 2009-10-28 |