| NPI | 1659540763 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MUSU KAISAMBA JUSU Owner 904-714-1020 |
| Organization Subpart ? | No |
| Primary Taxonomy | 164W00000X Licensed Practical Nurse (Licence: FL PN5159858) |
| Enumeration Date | 2008-02-22 |
| Last Update Date | 2008-02-22 |