| NPI | 1215051719 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JODY ELLEN GREEN Owner 301-530-9200 |
| Organization Subpart ? | No |
| Primary Taxonomy | 2084N0400X Psychiatry & Neurology, Neurology (Licence: MD D0052444) |
| Additional Taxonomies | 208VP0000X Pain Medicine, Pain Medicine (Licence: MD D0052444) |
| Enumeration Date | 2007-03-19 |
| Last Update Date | 2020-08-22 |