| NPI | 1538912423 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | GLORY DIOH-ESONA Owner 404-494-6774 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine |
| Additional Taxonomies | 363LP0808X Nurse Practitioner, Psych/Mental Health |
| Enumeration Date | 2024-04-09 |
| Last Update Date | 2024-07-25 |