NPI | 1407013956 |
---|---|
Entity Type | Organization |
Authorized Contact | HAMID EHSANI-SHISHVAN Medical Director 410-707-0847 |
Organization Subpart ? | No |
Primary Taxonomy | 207Q00000X Family Medicine (Licence: MD D0065701) |
Additional Taxonomies | 261QP2300X Clinic/Center, Primary Care (Licence: MD D0065701) |
Enumeration Date | 2008-05-21 |
Last Update Date | 2008-08-29 |