| NPI | 1184994105 |
|---|---|
| Former Name | BERHANU KEDIDA EJIGU |
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: GA RN152429) |
| Additional Taxonomies | 163WH0200X Registered Nurse, Home Health (Licence: OR 202205124RN) |
| Enumeration Date | 2012-01-06 |
| Last Update Date | 2025-10-09 |