| NPI | 1295301315 |
|---|---|
| Former Name | MODUPE O OSUNKEYE |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: IL 209.023284) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: IL 041409665) |
| Enumeration Date | 2021-05-29 |
| Last Update Date | 2024-10-29 |