| NPI | 1740919836 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | NICHOLAS BORODULIA Md 410-430-5154 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine |
| Additional Taxonomies | 207R00000X Internal Medicine |
| Enumeration Date | 2022-06-06 |
| Last Update Date | 2022-06-06 |