| NPI | 1326464272 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LAURA A RUBY Owner 410-861-5256 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QH0100X Clinic/Center Health Service (Licence: MD R084575) |
| Enumeration Date | 2014-03-14 |
| Last Update Date | 2014-03-14 |