| NPI | 1023744240 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | QUEEN MBANUZUE Medical Director 443-300-8661 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QA1903X Clinic/Center Ambulatory Surgical |
| Additional Taxonomies | 208600000X Surgery |
| Enumeration Date | 2022-07-29 |
| Last Update Date | 2023-04-21 |