| NPI | 1194197152 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MOHAMMED KIDDUGAVU Owner 410-922-2650 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207RI0200X Internal Medicine, Infectious Disease (Licence: MD D0070832) |
| Enumeration Date | 2015-10-29 |
| Last Update Date | 2016-09-14 |