| NPI | 1699954750 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JEANIE BERNICE STREET Administrative Assistant 410-266-8601 |
| Organization Subpart ? | No |
| Primary Taxonomy | 174400000X Specialist (Licence: MD D0014758) |
| Enumeration Date | 2007-10-25 |
| Last Update Date | 2008-10-08 |