| NPI | 1659183721 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LORI DIXON Director, Finance 301-533-4251 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 208000000X Pediatrics |
| Additional Taxonomies | 363A00000X Physician Assistant |
| 363LP0200X Nurse Practitioner, Pediatrics | |
| Enumeration Date | 2025-01-24 |
| Last Update Date | 2025-07-10 |