| NPI | 1710699137 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KERNIBA Y GHONEIM Co Owner 202-621-8713 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM1300X Clinic/Center Multi-Specialty |
| Additional Taxonomies | 363LP0808X Nurse Practitioner Psychiatric/Mental Health |
| Enumeration Date | 2022-12-16 |
| Last Update Date | 2023-02-14 |