| NPI | 1013184159 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ALICE PATRICIA TANNER Pediatrician/Practice Owner 410-768-2231 |
| Organization Subpart ? | No |
| Primary Taxonomy | 2080A0000X Pediatrics, Adolescent Medicine |
| Enumeration Date | 2008-05-08 |
| Last Update Date | 2008-05-08 |