| NPI | 1568109189 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CELINE CHANG Nurse Practitioner/Owner 443-492-9466 |
| Organization Subpart ? | No |
| Primary Taxonomy | 208000000X Pediatrics |
| Additional Taxonomies | 261Q00000X Clinic/Center |
| Enumeration Date | 2022-05-16 |
| Last Update Date | 2022-09-12 |