| NPI | 1235282906 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MICHELLE LYNN SCHAFFNER Office Manager 410-938-8660 |
| Organization Subpart ? | No |
| Primary Taxonomy | 174400000X Specialist (Licence: MD 15102) |
| Enumeration Date | 2007-01-18 |
| Last Update Date | 2013-07-09 |