| NPI | 1992680292 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | EREWARIFAGHA M HAIDOME Owner 347-281-0304 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363LX0106X Nurse Practitioner, Occupational Health |
| Enumeration Date | 2025-08-07 |
| Last Update Date | 2025-08-07 |