| NPI | 1457099293 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MIRANDA MBUTAMBE Administrator 202-367-3927 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 261QM1300X Clinic/Center Multi-Specialty |
| Additional Taxonomies | 363LF0000X Nurse Practitioner Family |
| Enumeration Date | 2022-05-23 |
| Last Update Date | 2022-05-23 |