| NPI | 1073043824 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ZEBUN NISA Managing Member 443-907-5756 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: MD D64083) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: MD D64019) |
| Enumeration Date | 2017-06-14 |
| Last Update Date | 2023-07-03 |