| NPI | 1790428555 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SALLY OWIE YOUNG Educator 240-437-9997 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QP2300X Clinic/Center, Primary Care |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family |
| Enumeration Date | 2022-04-19 |
| Last Update Date | 2022-07-14 |