| NPI | 1801550140 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ABISOYE SOMORIN Ap RN 386-872-8534 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health |
| Additional Taxonomies | 261QP2300X Clinic/Center, Primary Care |
| 363L00000X Nurse Practitioner | |
| Enumeration Date | 2021-10-22 |
| Last Update Date | 2024-03-27 |