| NPI | 1871157529 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | QUEEN IDOWU Owner 281-827-2214 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363LA2200X Nurse Practitioner, Adult Health |
| Additional Taxonomies | 363LG0600X Nurse Practitioner, Gerontology |
| 363LP0808X Nurse Practitioner, Psych/Mental Health | |
| Enumeration Date | 2019-04-29 |
| Last Update Date | 2024-07-29 |