| NPI | 1093313652 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LETICIA GRACIELA BUSTAMANTE SANCHEZ C RN P 301-818-7272 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QP2300X Clinic/Center Primary Care |
| Additional Taxonomies | 261QM1300X Clinic/Center Multi-Specialty |
| Enumeration Date | 2020-10-15 |
| Last Update Date | 2022-06-10 |