| NPI | 1760122105 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ENOCH ANYANWU Owner Of Entity 781-650-1039 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health |
| Enumeration Date | 2022-04-01 |
| Last Update Date | 2022-04-01 |