| NPI | 1033532460 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | NANCY DENNISSE RIVERA-KING Owner 410-353-9323 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QP2300X Clinic/Center, Primary Care (Licence: MD D0040904) |
| Enumeration Date | 2014-01-21 |
| Last Update Date | 2014-01-21 |