| NPI | 1699134049 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | EGHOSA ODOBO Owner 678-358-4681 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family |
| Additional Taxonomies | 363LP2300X Nurse Practitioner, Primary Care |
| Enumeration Date | 2016-02-13 |
| Last Update Date | 2016-02-13 |