| NPI | 1730450990 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LOUIS GBONE Manager 240-426-3133 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QP2300X Clinic/Center, Primary Care (Licence: MD D0069829) |
| Enumeration Date | 2012-01-19 |
| Last Update Date | 2021-09-21 |