| NPI | 1316515372 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | PHILIP WISOTSKY Medical Director 301-870-0660 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine |
| Additional Taxonomies | 207QG0300X Family Medicine, Geriatric Medicine |
| Enumeration Date | 2021-06-16 |
| Last Update Date | 2021-11-22 |