| NPI | 1306063177 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MIKEL DANIELS Owner 410-363-4343 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QA1903X Clinic/Center Ambulatory Surgical (Licence: MD M00338) |
| Enumeration Date | 2007-04-20 |
| Last Update Date | 2012-11-13 |