| NPI | 1083000939 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JEFFREY GREEN Provider 301-332-0467 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QH0100X Clinic/Center, Health Services (Licence: MD D0031283) |
| Enumeration Date | 2015-04-07 |
| Last Update Date | 2015-04-07 |