Individual
ENDAH FOMUKI
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
5307 LOTUS CANYON CT, RICHMOND, TX 77407-1448
(617) 308-6106
Mailing address
5307 LOTUS CANYON CT, RICHMOND, TX 77407-1448
(617) 308-6106
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
911174
TX
Other
Enumeration date
02/27/2018
Last updated
02/27/2018
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