| NPI | 1609247030 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TIM DELBRUGGE CFO 443-949-0814 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: PA OS007508L) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: PA OS007508L) |
| Enumeration Date | 2015-10-12 |
| Last Update Date | 2022-02-24 |