| NPI | 1275710261 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | OLADIMEJI OLUMIDE SORUNKE CEO 817-723-3638 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363AM0700X Physician Assistant, Medical (Licence: TX PA03163) |
| Enumeration Date | 2008-01-22 |
| Last Update Date | 2008-01-22 |