| NPI | 1518332949 | 
|---|---|
| Entity Type | Organization | 
| Authorized Contact | WILLIAM ZIRKIN Treasurer 443-797-2074 | 
| Organization Subpart ? | No | 
| Primary Taxonomy | 207P00000X Emergency Medicine | 
| Additional Taxonomies | 363A00000X Physician Assistant | 
| 363L00000X Nurse Practitioner | |
| Enumeration Date | 2015-12-10 | 
| Last Update Date | 2023-11-29 |