| NPI | 1154868727 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | RALPH JAY UPDIKE Vice President 410-934-5423 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261Q00000X Clinic/Center (Licence: MD 03003633) |
| Enumeration Date | 2017-01-20 |
| Last Update Date | 2017-01-26 |