| NPI | 1619605672 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | GREGORY P FOTI Vice President And Secretary 443-738-0225 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM1300X Clinic/Center, Multi-Specialty |
| Enumeration Date | 2022-08-09 |
| Last Update Date | 2024-05-16 |