| NPI | 1619280484 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | STEPHEN WANDER Owner 301-770-1818 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine |
| Additional Taxonomies | 363L00000X Nurse Practitioner |
| 208100000X Physical Medicine & Rehabilitation | |
| 363LF0000X Nurse Practitioner, Family | |
| Enumeration Date | 2010-07-21 |
| Last Update Date | 2011-03-15 |