| NPI | 1124844840 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MARGIE OLLER BURR Director Of Professional Fees 410-706-5181 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QP2300X Clinic/Center, Primary Care |
| Additional Taxonomies | 208000000X Pediatrics |
| 281PC2000X Chronic Disease Hospital, Children | |
| Enumeration Date | 2024-11-26 |
| Last Update Date | 2025-04-14 |