| NPI | 1619777497 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MARY REBECCA WRIGHT-SISK Director 443-422-9941 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207XX0005X Orthopaedic Surgery Sports Medicine |
| Enumeration Date | 2025-03-19 |
| Last Update Date | 2025-03-19 |