| NPI | 1639441017 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | VICTORIA ENYOGAI Credentialing Manager 301-483-7999 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QP2300X Clinic/Center Primary Care (Licence: MD D0026012) |
| Enumeration Date | 2012-02-01 |
| Last Update Date | 2013-05-28 |