| NPI | 1285310847 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | RUBY LEE Authorized Official 240-203-8881 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM1300X Clinic/Center Multi-Specialty |
| Additional Taxonomies | 207Q00000X Family Medicine |
| 3336C0002X Pharmacy Clinic Pharmacy | |
| Enumeration Date | 2023-06-27 |
| Last Update Date | 2025-08-13 |