Individual
KINGSLY FOMBUTU GABILA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
1512 BRIGHTSEAT RD APT 202, LANDOVER, MD 20785-3755
(240) 476-0847
Mailing address
1512 BRIGHTSEAT RD APT 202, LANDOVER, MD 20785-3755
(240) 476-0847
Taxonomy
Speciality
Code
Description
License number
State
374U00000X
Home Health Aide
Primary
HHA14542
DC
Other
Enumeration date
07/15/2019
Last updated
07/15/2019
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