| NPI | 1407747900 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MESFIN WANNA Owner 571-645-6767 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363LP2300X Nurse Practitioner, Primary Care |
| Additional Taxonomies | 363LA2200X Nurse Practitioner, Adult Health |
| 363LG0600X Nurse Practitioner, Gerontology | |
| Enumeration Date | 2025-07-12 |
| Last Update Date | 2025-07-12 |