| NPI | 1700075686 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CAROL LYN CWIK Director Of Administrative Affairs 410-247-4740 |
| Organization Subpart ? | No |
| Primary Taxonomy | 174400000X Specialist (Licence: MD D0025902) |
| Enumeration Date | 2007-10-17 |
| Last Update Date | 2009-10-28 |