Individual
HENRY JITUBOH
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
3105 EDGEBROOK CT, WYLIE, TX 75098-8511
(718) 663-1475
Mailing address
3105 EDGEBROOK CT, WYLIE, TX 75098-8511
(718) 663-1475
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
941538
TX
Other
Enumeration date
04/09/2018
Last updated
04/09/2018
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