| NPI | 1134605009 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | OLUYEMISI FAMUYIIWA Director 301-442-8548 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QA1903X Clinic/Center, Ambulatory Surgical |
| Additional Taxonomies | 261QR0200X Clinic/Center, Radiology |
| 291U00000X Clinical Medical Laboratory | |
| Enumeration Date | 2018-07-13 |
| Last Update Date | 2018-08-28 |