| NPI | 1710545900 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ISAAC O BOFAH Owner Of Entity 216-220-7557 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health |
| Enumeration Date | 2019-06-03 |
| Last Update Date | 2019-06-03 |