| NPI | 1184399883 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | THOMAS J TRENTLY CFO 443-738-0281 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207RI0200X Internal Medicine, Infectious Disease |
| Additional Taxonomies | 207Q00000X Family Medicine |
| Enumeration Date | 2021-08-13 |
| Last Update Date | 2021-08-13 |