| NPI | 1164984977 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LEONARD RICHARDSON Owner/Provider 410-336-4932 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine |
| Additional Taxonomies | 207Q00000X Family Medicine |
| Enumeration Date | 2019-04-01 |
| Last Update Date | 2019-04-01 |