| NPI | 1881174654 |
|---|---|
| Former Name | FAUSAT FUNMILOLA FATOKUN |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: NY 402510) |
| Additional Taxonomies | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: NJ 26NR22474600) |
| Enumeration Date | 2018-08-21 |
| Last Update Date | 2024-09-23 |