| NPI | 1184421687 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CHANEL MORRIS Administrative/Credentialing 410-494-1237 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM1300X Clinic/Center Multi-Specialty |
| Additional Taxonomies | 207N00000X Dermatology |
| Enumeration Date | 2025-03-03 |
| Last Update Date | 2025-03-25 |