| NPI | 1124423637 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | RANDYL ERIK GESSEL President 301-662-6478 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363AM0700X Physician Assistant, Medical (Licence: MD C04452) |
| Additional Taxonomies | 171100000X Acupuncturist (Licence: MD U0213) |
| Enumeration Date | 2014-10-27 |
| Last Update Date | 2014-11-10 |