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Individual

DI LEONEL NTUI NTUI

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man

Contact information

Practice address
780 FAIRVIEW AVE APT 507, TAKOMA PARK, MD 20912-5950
(240) 515-2355
Mailing address
14010 LAKE MEADOWS DR, BOWIE, MD 20720-3812
(240) 515-2355

Taxonomy

Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
RN1047013
DC
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
R228821
MD

Other

Enumeration date
10/03/2018
Last updated
11/19/2024
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