| NPI | 1336944321 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CHRIS KIRBY Credentialing Administrator 301-565-2250 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine |
| Additional Taxonomies | 208100000X Physical Medicine & Rehabilitation |
| Enumeration Date | 2025-02-14 |
| Last Update Date | 2025-02-14 |