| NPI | 1043538002 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TOMEKA DANIELLE RUSSELL Physician Owner 301-379-1733 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: AL MD25934) |
| Enumeration Date | 2010-05-14 |
| Last Update Date | 2010-07-06 |