| NPI | 1578336152 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JOVITA EZIRIM-SALAMIALOFOJE Secretary 409-356-9778 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health |
| Enumeration Date | 2023-11-06 |
| Last Update Date | 2024-02-12 |