| NPI | 1861229049 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SCOTT R LILLY CEO 301-663-6162 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 207Q00000X Family Medicine |
| Additional Taxonomies | 133V00000X Dietitian, Registered |
| 363LP0200X Nurse Practitioner, Pediatrics | |
| Enumeration Date | 2024-09-19 |
| Last Update Date | 2024-11-04 |