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 |