| NPI | 1316797145 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | EUCHARIA ANYICHIE Administrator 346-220-3534 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family |
| Additional Taxonomies | 261QP2300X Clinic/Center, Primary Care |
| Enumeration Date | 2024-03-25 |
| Last Update Date | 2025-03-27 |