Individual
MR. AJIROGHENE DAVID OMINIABOHS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
LPN
Contact information
Practice address
487 E 92ND ST, BROOKLYN, NY 11212-1007
(347) 528-8298
Mailing address
487 E 92ND ST, BROOKLYN, NY 11212-1007
(347) 528-8298
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
303237
NY
Other
Enumeration date
04/04/2012
Last updated
04/04/2012
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