| NPI | 1518989474 |
|---|---|
| Former Name | JELIL OMOTAYO ONANUGA |
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2084P0800X Psychiatry & Neurology Psychiatry (Licence: TX P7684) |
| Additional Taxonomies | 2084P0800X Psychiatry & Neurology Psychiatry (Licence: NY 240216) |
| Enumeration Date | 2006-07-23 |
| Last Update Date | 2019-01-09 |