| NPI | 1487401816 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ADEWUNMI JULIUS BANKOLE Owner 516-350-8564 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health |
| Enumeration Date | 2024-05-03 |
| Last Update Date | 2024-05-03 |