Individual
FNU HERMANN NGEVE MBULAV
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
4609 30TH ST, MOUNT RAINIER, MD 20712-1316
(240) 906-1821
Mailing address
4609 30TH ST, MOUNT RAINIER, MD 20712-1316
(240) 906-1821
Taxonomy
Speciality
Code
Description
License number
State
374U00000X
Home Health Aide
Primary
HHA14315
DC
Other
Enumeration date
03/13/2019
Last updated
03/13/2019
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