| NPI | 1982304713 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DANIEL DISTEFANO Operations Manager 202-932-9958 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine |
| Additional Taxonomies | 207R00000X Internal Medicine |
| 207RE0101X Internal Medicine, Endocrinology, Diabetes & Metabolism | |
| 208D00000X General Practice | |
| 261QM1300X Clinic/Center, Multi-Specialty | |
| Enumeration Date | 2023-03-09 |
| Last Update Date | 2024-10-23 |