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Individual
MR. KELLIE FAGBOWA MARAH
Active
Individual
MR. KELLIE FAGBOWA MARAH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
RN1028482
DC
163WM0705X
Medical-Surgical Registered Nurse
R203641
MD
163WM0705X
Medical-Surgical Registered Nurse
Primary
RN1028482
DC
Other
Enumeration date
08/30/2016
Last updated
08/30/2016
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