| NPI | 1033481718 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TERRY P DETRICH Owner 410-822-6677 |
| Organization Subpart ? | No |
| Primary Taxonomy | 2084N0400X Psychiatry & Neurology Neurology (Licence: MD D12893) |
| Enumeration Date | 2012-01-27 |
| Last Update Date | 2012-01-27 |