Individual
HERMANN JUMBAM TATA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
14007 BRAMBLE LN APT 202, LAUREL, MD 20708-1283
(240) 923-4470
Mailing address
14007 BRAMBLE LN APT 202, LAUREL, MD 20708-1283
(240) 923-4470
Taxonomy
Speciality
Code
Description
License number
State
171M00000X
Case Manager/Care Coordinator
Primary
—
—
Other
Enumeration date
07/31/2024
Last updated
07/31/2024
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