| NPI | 1023795945 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | BULAT KHAMITOV CEO 240-848-7692 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner |
| Additional Taxonomies | 261QP2300X Clinic/Center Primary Care |
| Enumeration Date | 2023-07-03 |
| Last Update Date | 2025-03-22 |