NPI | 1386127751 |
---|---|
Entity Type | Organization |
Authorized Contact | IMELDA T RUSSELL Partner 703-244-4633 |
Organization Subpart ? | No |
Primary Taxonomy | 363L00000X Nurse Practitioner |
Additional Taxonomies | 363LA2200X Nurse Practitioner, Adult Health |
363LF0000X Nurse Practitioner, Family | |
Enumeration Date | 2018-09-12 |
Last Update Date | 2018-10-01 |