Individual
IDAYAT DASOLA JIMOH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
8816 NW 85TH ST, OKLAHOMA CITY, OK 73132-4078
(405) 370-8840
Mailing address
8816 NW 85TH ST, OKLAHOMA CITY, OK 73132-4078
(405) 370-8840
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
106104
OK
Other
Enumeration date
11/10/2017
Last updated
11/10/2017
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