| NPI | 1285768739 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KOJO A POBEE Owner 469-323-8556 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363LG0600X Nurse Practitioner Gerontology (Licence: TX 647333) |
| Additional Taxonomies | 207RG0300X Internal Medicine Geriatric Medicine (Licence: TX K7592) |
| Enumeration Date | 2007-03-15 |
| Last Update Date | 2025-01-24 |