| NPI | 1972358695 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | NKEIRUKA ODUAGU MADUBUEZE Psychiatric Nurse Practitioner 315-480-4252 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health |
| Enumeration Date | 2024-04-18 |
| Last Update Date | 2024-04-18 |