| NPI | 1104120260 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DUANGMARL P MALAYAMAN Secretary 410-644-3212 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: MD D18396) |
| Enumeration Date | 2011-01-04 |
| Last Update Date | 2011-01-04 |