Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 363LF0000X | Nurse Practitioner - Family Medicine | AP130849 | TX |
NPI | 1003264755 |
---|---|
Provider Name | Emiola Sanni |
First Address | Cerritos, CA 90703-9329 |
Second Address | Houston, TX 77098-3706 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 02/06/2016 |
Last Update Date | 27/11/2019 |