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Individual
MR. EMMANUEL AGWAGOM
Active
Individual
MR. EMMANUEL AGWAGOM
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
RN
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
742099
TX
163WC1500X
Community Health Registered Nurse
26NR11805800
NJ
171M00000X
Case Manager/Care Coordinator
Primary
742099
TX
Other
Enumeration date
02/17/2010
Last updated
02/17/2010
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