| NPI | 1215399803 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CASTEL ALANIZ SANTANA Owner/Physician 443-710-7422 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: OK 30855) |
| Enumeration Date | 2016-03-23 |
| Last Update Date | 2016-04-21 |