| NPI | 1124364757 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ETA STEPHEN TATAW Owner 301-982-7898 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner Family (Licence: MD R178223) |
| Enumeration Date | 2013-01-01 |
| Last Update Date | 2023-02-24 |