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Individual
OMOBOLA FASHOLA
Active
Individual
OMOBOLA FASHOLA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
644419
CA
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
95022795
CA
Other
Enumeration date
02/08/2021
Last updated
01/26/2023
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