| NPI | 1912721895 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JOHN NGUGI Sole Proprietor 443-248-1929 |
| Organization Subpart ? | No |
| Primary Taxonomy | 208VP0000X |
| Additional Taxonomies | 208D00000X General Practice |
| Enumeration Date | 2024-11-08 |
| Last Update Date | 2025-04-15 |