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1134891633
LUCAS MBAKWA FONCHAM
TAKOMA PARK, MD
NPI
1134891633
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
376K00000X Nurse's Aide
Enumeration Date
2021-10-02
Last Update Date
2021-10-02
Business Address
LUCAS MBAKWA FONCHAM
780 FAIRVIEW AVE APT 605
TAKOMA PARK, MD 20912-5951
Phone number: 202-779-2523
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Mailing Address
LUCAS MBAKWA FONCHAM
780 FAIRVIEW AVE APT 605
TAKOMA PARK, MD 20912-5951
Phone number:
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