| NPI | 1790478782 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KOMI KOUTCHE Sole Mbr 202-855-1516 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine |
| Additional Taxonomies | 208000000X Pediatrics |
| 363AM0700X Physician Assistant, Medical | |
| 363LF0000X Nurse Practitioner, Family | |
| Enumeration Date | 2023-05-26 |
| Last Update Date | 2023-05-26 |