| NPI | 1710237037 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CANDICE MICHELLE BOSWELL Office Manager 301-645-1781 |
| Organization Subpart ? | No |
| Primary Taxonomy | 208000000X Pediatrics (Licence: MD D0064240) |
| Enumeration Date | 2012-09-13 |
| Last Update Date | 2014-12-19 |