| NPI | 1043595648 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | PAIGE SMITH Billing Supervisor 301-509-4091 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363LG0600X Nurse Practitioner, Gerontology (Licence: MD R136830) |
| Enumeration Date | 2011-10-14 |
| Last Update Date | 2019-01-14 |