| NPI | 1477229789 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JUDE C EMELUMBA Owner Of Entity 551-247-8105 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health |
| Enumeration Date | 2021-08-17 |
| Last Update Date | 2022-03-08 |