| NPI | 1568533099 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KELLY J ROSEMOND Practice Manager 301-897-1503 |
| Organization Subpart ? | No |
| Primary Taxonomy | 174400000X Specialist (Licence: MD D0037236) |
| Enumeration Date | 2006-11-13 |
| Last Update Date | 2011-01-04 |