| NPI | 1144975095 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | OLUKAYODE AGUNBIADE Nurse Practitioner 862-215-5643 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health |
| Enumeration Date | 2022-02-18 |
| Last Update Date | 2022-02-18 |