| NPI | 1184217440 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | OLUREMI ILUPEJU Provider / Owner 301-439-4422 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0801X |
| Additional Taxonomies | 363LP0808X Nurse Practitioner, Psych/Mental Health |
| Enumeration Date | 2021-02-18 |
| Last Update Date | 2024-01-30 |