| NPI | 1558834069 |
|---|---|
| Former Legal Business Name | QUEENSHADE |
| Entity Type | Organization |
| Authorized Contact | FOLASHADE ADEBIYI Supervisor 862-576-3281 |
| Organization Subpart ? | No |
| Primary Taxonomy | 163W00000X Registered Nurse |
| Enumeration Date | 2019-01-08 |
| Last Update Date | 2019-01-08 |