| NPI | 1346254760 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JESSICA CORNELL Credentialing 410-398-4679 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: MD D0007463) |
| Enumeration Date | 2006-07-28 |
| Last Update Date | 2020-08-22 |