| NPI | 1225776834 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JUDITH FUAJONG NGULEFAC Np 757-706-1776 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health |
| Additional Taxonomies | 363LP2300X Nurse Practitioner, Primary Care |
| Enumeration Date | 2022-05-24 |
| Last Update Date | 2024-07-29 |