| NPI | 1093724163 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | GENEROSA CRUZ LAZOR Director 410-569-9533 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QP2300X Clinic/Center Primary Care (Licence: MD D34413) |
| Enumeration Date | 2006-08-06 |
| Last Update Date | 2014-12-29 |