| NPI | 1760668081 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MAIYA CLARK Owner 410-570-3372 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QP2300X Clinic/Center, Primary Care (Licence: MD D0061964) |
| Enumeration Date | 2008-01-16 |
| Last Update Date | 2016-11-03 |