| NPI | 1538994678 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | IZEHI AGENMOMEN EROMOSELE Np 646-287-0094 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health |
| Enumeration Date | 2024-09-06 |
| Last Update Date | 2025-09-17 |