| NPI | 1659563427 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DAVID P BOERSMA Pcp/Owner 410-823-5532 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QP2300X Clinic/Center, Primary Care (Licence: MD D0040048) |
| Enumeration Date | 2007-08-15 |
| Last Update Date | 2007-08-15 |