| NPI | 1750528352 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LEONID GORBATOV Administrator /Officer 301-366-3844 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261Q00000X Clinic/Center (Licence: MA 261Q00000X) |
| Enumeration Date | 2009-01-19 |
| Last Update Date | 2009-01-19 |