| NPI | 1043497290 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | THEODORE C. OSUALA Medical Director 301-577-9111 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261Q00000X Clinic/Center (Licence: MD DOO64126) |
| Enumeration Date | 2008-01-29 |
| Last Update Date | 2022-08-02 |