| NPI | 1699220731 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TERESA MARIE LUM Owner 240-513-4595 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363LP0200X Nurse Practitioner, Pediatrics (Licence: MD R109055) |
| Enumeration Date | 2016-08-18 |
| Last Update Date | 2016-08-18 |