| NPI | 1306092739 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | IFEOLUMPO O. SOFOLA Ent 301-787-8914 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QA1903X Clinic/Center Ambulatory Surgical (Licence: TX 007917) |
| Enumeration Date | 2008-08-18 |
| Last Update Date | 2008-08-18 |