| NPI | 1255097150 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | BERN M SIMO MUKAM Owner 240-338-0226 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363LP0808X Nurse Practitioner Psychiatric/Mental Health |
| Enumeration Date | 2021-11-15 |
| Last Update Date | 2021-11-15 |