| NPI | 1326525973 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DEBORAH AGUS Executive Director 410-367-5878 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207RA0401X Internal Medicine Addiction Medicine |
| Enumeration Date | 2018-07-26 |
| Last Update Date | 2018-07-26 |