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Individual

ABIMBOLA A ODUKOYA

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
M.D.

Taxonomy

Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
01062400A
IN
208000000X
Pediatrics Physician
61002723
NY

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
01062400A
IN STATE LICENSE
IN
05
200908770
IN
01
61002723
LICENSE
NY
Enumeration date
09/22/2006
Last updated
10/15/2015
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