| NPI | 1952033011 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CHINYENUM OTUYA Owner 240-476-3951 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363LP2300X Nurse Practitioner, Primary Care |
| Additional Taxonomies | 363LG0600X Nurse Practitioner, Gerontology |
| Enumeration Date | 2022-06-28 |
| Last Update Date | 2023-11-17 |