| NPI | 1174917736 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TATYANA REZNIKOV Mbr 410-833-1101 |
| Organization Subpart ? | No |
| Primary Taxonomy | 2081P2900X Physical Medicine & Rehabilitation, Pain Medicine |
| Enumeration Date | 2015-03-22 |
| Last Update Date | 2016-01-29 |