| NPI | 1366031973 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LOUIS GBONE Manager 301-966-2558 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family |
| Additional Taxonomies | 261QH0100X Clinic/Center, Health Services |
| Enumeration Date | 2021-01-18 |
| Last Update Date | 2023-01-24 |