| NPI | 1194035097 | 
|---|---|
| Entity Type | Organization | 
| Authorized Contact | BOONYONG P THADA Physician 410-358-5111  | 
| Organization Subpart ? | Yes | 
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: MD D0019823)  | 
| Enumeration Date | 2010-10-14 | 
| Last Update Date | 2010-10-19 |