| NPI | 1871228973 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | OMOTOLU OLAITAN AJE-OMOKORE Provider 316-990-4126 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health |
| Enumeration Date | 2022-07-21 |
| Last Update Date | 2022-07-23 |