| NPI | 1194120808 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MARCIA JACOBS Owner 301-633-0906 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM2500X Clinic/Center, Medical Specialty (Licence: MD 000676 MD) |
| Enumeration Date | 2014-10-24 |
| Last Update Date | 2015-03-26 |