| NPI | 1407674104 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | GREGORY P. FOTI President 443-738-0225 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM1300X Clinic/Center, Multi-Specialty |
| Additional Taxonomies | 251S00000X |
| Enumeration Date | 2024-10-01 |
| Last Update Date | 2024-11-05 |