| NPI | 1700612587 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MARGIE OLLER BURR Director Of Professional Fees 410-706-5181 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM1300X Clinic/Center, Multi-Specialty |
| Additional Taxonomies | 208000000X Pediatrics |
| Enumeration Date | 2024-09-10 |
| Last Update Date | 2024-09-10 |