| NPI | 1710115472 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DOMENICK COLETTI Director 410-997-1010 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QA1903X Clinic/Center, Ambulatory Surgical (Licence: MD A1497) |
| Enumeration Date | 2009-07-01 |
| Last Update Date | 2013-05-08 |