| NPI | 1700166360 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SHEETAL HARISH WAGLE Sole Owner 410-988-4013 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261Q00000X Clinic/Center (Licence: MD D0072106) |
| Enumeration Date | 2011-08-26 |
| Last Update Date | 2011-08-26 |