Individual
GWANGWA FAGHA THOMAS BRAINE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
702 15TH ST NE, WASHINGTON, DC 20002-4508
(301) 674-1699
Mailing address
702 15TH ST NE, WASHINGTON, DC 20002-4508
Taxonomy
Speciality
Code
Description
License number
State
172V00000X
Community Health Worker
Primary
—
—
Other
Enumeration date
07/26/2024
Last updated
07/26/2024
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