| NPI | 1598583320 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JAMES KANUCH Chief Financial Officer 410-641-9602 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 208000000X Pediatrics |
| Additional Taxonomies | 207Q00000X Family Medicine |
| 207R00000X Internal Medicine | |
| Enumeration Date | 2024-10-01 |
| Last Update Date | 2024-10-01 |