| NPI | 1306378849 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | OLAKUNLE SOWUNMI Director 202-341-1240 |
| Organization Subpart ? | No |
| Primary Taxonomy | 302F00000X Exclusive Provider Organization (Licence: AZ 1978) |
| Enumeration Date | 2017-04-03 |
| Last Update Date | 2017-04-03 |