| NPI | 1780825224 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DAINTY J JACKSON Doctor 301-885-3350 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QP2300X Clinic/Center, Primary Care (Licence: MD H0058218) |
| Enumeration Date | 2009-03-12 |
| Last Update Date | 2009-03-12 |