| NPI | 1770544611 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | IRIS MARY CRAWFORD Office/Billing Manager 410-876-7616 |
| Organization Subpart ? | No |
| Primary Taxonomy | 2080A0000X Pediatrics Adolescent Medicine |
| Enumeration Date | 2006-03-30 |
| Last Update Date | 2020-08-22 |