| NPI | 1801960885 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JERRY THOMAS Md 301-604-3228 |
| Organization Subpart ? | No |
| Primary Taxonomy | 174400000X Specialist (Licence: MD D50349) |
| Additional Taxonomies | 174400000X Specialist (Licence: MD D24388) |
| 174400000X Specialist (Licence: MD D47363) | |
| 174400000X Specialist (Licence: MD D41258) | |
| Enumeration Date | 2006-11-20 |
| Last Update Date | 2008-06-23 |