| NPI | 1700526142 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | NGUM AVWONTOM President 301-404-1989 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207QA0505X Family Medicine, Adult Medicine |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family |
| Enumeration Date | 2022-04-01 |
| Last Update Date | 2022-04-01 |