| NPI | 1710683156 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | NDIDIAMAKA EZINNE MBAKPUO CEO 301-712-4637 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261Q00000X |
| Additional Taxonomies | 261QU0200X Clinic/Center, Urgent Care |
| 363LF0000X Nurse Practitioner, Family | |
| Enumeration Date | 2023-02-07 |
| Last Update Date | 2023-09-05 |