| NPI | 1235793258 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | RHONDA R STEWART Credentialing Specialist 240-274-4642 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363LA2200X Nurse Practitioner, Adult Health |
| Enumeration Date | 2019-04-25 |
| Last Update Date | 2019-04-25 |