| NPI | 1215686951 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LYLE MCNEILL CRIPPEN Credentialing 240-449-3094 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine |
| Additional Taxonomies | 1041C0700X Social Worker Clinical |
| 133V00000X Dietitian, Registered | |
| 363L00000X Nurse Practitioner | |
| Enumeration Date | 2022-03-21 |
| Last Update Date | 2022-03-21 |