| NPI | 1285289884 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | PATRICK OBINNA OLEDIMMAH Apn 862-368-5801 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363LP0808X Nurse Practitioner Psychiatric/Mental Health |
| Enumeration Date | 2019-08-09 |
| Last Update Date | 2019-08-09 |