| NPI | 1649015876 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | AMAECHI FIDELIA EGBUJUO Manager 772-607-0782 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363LP0808X Nurse Practitioner Psychiatric/Mental Health |
| Enumeration Date | 2024-06-28 |
| Last Update Date | 2024-06-28 |