| NPI | 1386898443 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SRIRAM H BALASUBRAMANIAN Owner 410-569-1001 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QP2300X Clinic/Center Primary Care (Licence: MD D52279) |
| Enumeration Date | 2008-11-14 |
| Last Update Date | 2010-06-01 |