| NPI | 1790282853 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TERI HARRINGTON CAMILLE Hr 443-909-6034 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant |
| Additional Taxonomies | 261QU0200X Clinic/Center, Urgent Care |
| Enumeration Date | 2018-04-06 |
| Last Update Date | 2024-09-03 |