| NPI | 1467614032 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KRISTIN MARIE CLARK Physician And Owner 410-730-8288 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QP2300X Clinic/Center, Primary Care (Licence: MD d53966) |
| Enumeration Date | 2008-06-25 |
| Last Update Date | 2011-03-04 |