| NPI | 1417712662 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ZYGMUNT PORADA Treasurer 443-641-6227 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine |
| Additional Taxonomies | 207QB0002X Family Medicine, Bariatric Medicine |
| Enumeration Date | 2024-02-16 |
| Last Update Date | 2024-02-16 |