Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2080P0210X | Pediatric Nephrologist | S0869 | TX |
NPI | 1841633823 |
---|---|
Provider Name | Oluwadamilola Ejike |
First Address | San Antonio, TX 78207-3100 |
Second Address | San Antonio, TX 78207-3100 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 09/04/2013 |
Last Update Date | 13/10/2021 |