| NPI | 1184393159 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DORIS CUDJOE OWUSU Owner 571-315-3313 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM1300X Clinic/Center, Multi-Specialty |
| Additional Taxonomies | 261QM0801X |
| Enumeration Date | 2021-09-12 |
| Last Update Date | 2023-12-05 |