| NPI | 1447205430 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LELAND DAVID SPENCER Physician Program Manager Ii 410-479-8550 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251K00000X Public Health or Welfare (Licence: MD D0027046) |
| Enumeration Date | 2006-05-24 |
| Last Update Date | 2020-08-22 |