| NPI | 1245953009 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | RAJIV DUA Medical Director 410-730-3399 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 207Q00000X Family Medicine |
| Additional Taxonomies | 207R00000X Internal Medicine |
| Enumeration Date | 2022-09-26 |
| Last Update Date | 2024-09-18 |