| 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 |