| NPI | 1780273839 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | HIEN QUANG NGUYEN Manager 443-553-4332 |
| Organization Subpart ? | No |
| Primary Taxonomy | 208D00000X General Practice |
| Additional Taxonomies | 291U00000X Clinical Medical Laboratory |
| 207QA0401X Family Medicine, Addiction Medicine | |
| Enumeration Date | 2021-01-13 |
| Last Update Date | 2023-09-01 |