| NPI | 1134852775 | 
|---|---|
| Entity Type | Organization | 
| Authorized Contact | NAZANEEN NASSIRY Owner/Authorized Official 571-839-0318 | 
| Organization Subpart ? | No | 
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family | 
| Enumeration Date | 2022-07-01 | 
| Last Update Date | 2022-07-01 |