| NPI | 1639487341 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JASON M LEE-LLACER Sole Owner 443-977-8406 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine |
| Additional Taxonomies | 207RC0200X Internal Medicine, Critical Care Medicine |
| Enumeration Date | 2010-09-15 |
| Last Update Date | 2010-09-15 |