| NPI | 1013890573 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JENNIFER RAE NEWCOMB Practice Manager 410-224-2116 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207RG0100X Internal Medicine Gastroenterology |
| Enumeration Date | 2025-07-30 |
| Last Update Date | 2025-07-30 |