| NPI | 1174179006 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | OLUFUNMILAYO ADESANLU Member 848-309-5141 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health |
| Enumeration Date | 2019-08-15 |
| Last Update Date | 2024-03-14 |