Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 103TH0100X | Health Service |
NPI | 1619237864 |
---|---|
Provider Name | Mrs. Azeezat Abimbola Awesu |
First Address | North East, DC 20019 |
Second Address | Washington, DC 20019-4573 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 22/05/2012 |
Last Update Date | 12/04/2018 |