| NPI | 1790978112 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JOSEPHINE M CRISOSTOMO Business Manager 301-645-7735 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QA1903X Clinic/Center, Ambulatory Surgical |
| Enumeration Date | 2007-08-20 |
| Last Update Date | 2007-08-20 |