| NPI | 1710079470 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ADAM GASTON TATTELBAUM Owner 240-747-5631 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QA1903X Clinic/Center Ambulatory Surgical (Licence: MD A1404) |
| Enumeration Date | 2006-09-29 |
| Last Update Date | 2020-08-22 |