| NPI | 1891044657 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | BRIAN J WISE CEO 571-449-2928 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner |
| Additional Taxonomies | 251J00000X Nursing Care |
| Enumeration Date | 2012-09-07 |
| Last Update Date | 2018-03-26 |