| NPI | 1669132767 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | GREGORY P FOTI President, Vice President, Treasure 443-738-0225 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM1300X Clinic/Center, Multi-Specialty |
| Enumeration Date | 2021-12-30 |
| Last Update Date | 2024-10-31 |