| NPI | 1720835523 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | PAUL STEPHEN NICHOLSON AO 410-337-1602 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine |
| Additional Taxonomies | 208000000X Pediatrics |
| Enumeration Date | 2024-05-01 |
| Last Update Date | 2024-05-01 |