| NPI | 1154022895 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MULUH FONGWI LADUNA FONDONG Np 218-779-9437 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health |
| Additional Taxonomies | 363LP2300X Nurse Practitioner, Primary Care |
| Enumeration Date | 2023-03-10 |
| Last Update Date | 2023-03-10 |