| NPI | 1245959840 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | GLORY NGUM FORBI Administrator 240-273-2054 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health |
| Additional Taxonomies | 363L00000X Nurse Practitioner |
| Enumeration Date | 2022-08-25 |
| Last Update Date | 2023-02-03 |