| NPI | 1639363559 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MARY ANN MOORE Owner 410-228-2603 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: MD D0031766) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: MD C0000549) |
| Enumeration Date | 2007-09-04 |
| Last Update Date | 2010-08-06 |