| NPI | 1720228463 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LUIS ANTONIO GONZALEZ Provider 301-933-6644 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: MD D0056791) |
| Enumeration Date | 2009-02-20 |
| Last Update Date | 2011-02-15 |