| NPI | 1669983904 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | EVELINE TAKANG Owner 240-264-9698 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363LP2300X Nurse Practitioner, Primary Care |
| Additional Taxonomies | 261QP2300X Clinic/Center, Primary Care |
| Enumeration Date | 2017-10-13 |
| Last Update Date | 2017-10-13 |