| NPI | 1124477096 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | WESLEY E COOK Medical Director 202-446-1085 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QP2300X Clinic/Center, Primary Care |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family |
| 363LP0808X Nurse Practitioner, Psych/Mental Health | |
| Enumeration Date | 2016-06-10 |
| Last Update Date | 2023-05-04 |