| NPI | 1043541147 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ROBERT JOHN TRACE Physician/Owner 301-739-2560 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207RG0100X Internal Medicine, Gastroenterology (Licence: MD D22012) |
| Enumeration Date | 2010-01-29 |
| Last Update Date | 2010-01-29 |