| NPI | 1306583448 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MELISSA HAHN Practice Manager 301-401-2248 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM2500X Clinic/Center, Medical Specialty |
| Additional Taxonomies | 174400000X Specialist |
| Enumeration Date | 2022-05-19 |
| Last Update Date | 2022-05-19 |