| NPI | 1578390175 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ANGELA RUTH PETERMAN Md 443-351-3376 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 207N00000X Dermatology |
| Additional Taxonomies | 174400000X Specialist |
| Enumeration Date | 2024-09-17 |
| Last Update Date | 2024-09-17 |