| NPI | 1710713094 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | EVELYN MOSES Administrator 301-517-6810 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM1300X Clinic/Center, Multi-Specialty |
| Additional Taxonomies | 261QA1903X Clinic/Center, Ambulatory Surgical |
| Enumeration Date | 2024-09-12 |
| Last Update Date | 2024-09-12 |