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1265068878
VITALIS EGWIM
COLTON, CA
NPI
1265068878
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
Yes
Primary Taxonomy
363L00000X Nurse Practitioner
(Licence: CA 95014012)
Enumeration Date
2020-03-14
Last Update Date
2020-03-14
Business Address
VITALIS EGWIM
1699 E WASHINGTON ST APT 2246
COLTON, CA 92324-6460
Phone number: 443-742-8019
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Mailing Address
VITALIS EGWIM
1699 E WASHINGTON ST APT 2246
COLTON, CA 92324-6460
Phone number: 443-742-8019
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