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Individual
MR. KODJO SENIOR EDOH
Active
Individual
MR. KODJO SENIOR EDOH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
RN
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
150820
KS
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
83479
KS
Other
Enumeration date
03/08/2023
Last updated
12/06/2024
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