NPI | 1063563203 |
---|---|
Entity Type | Organization |
Authorized Contact | LARRY W BLUM Owner Physician Manager 410-266-2740 |
Organization Subpart ? | No |
Primary Taxonomy | 174400000X Specialist (Licence: MD D37246) |
Enumeration Date | 2007-01-15 |
Last Update Date | 2009-02-05 |