| NPI | 1245108083 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | AGNES USORO Owner 346-741-6772 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine |
| Additional Taxonomies | 207Q00000X Family Medicine |
| Enumeration Date | 2025-10-24 |
| Last Update Date | 2025-10-24 |