| NPI | 1427622786 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TRACY RENNA THOMAS Credentialing Mgr 410-663-4036 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207RA0401X Internal Medicine, Addiction Medicine |
| Enumeration Date | 2021-05-19 |
| Last Update Date | 2022-07-28 |