| NPI | 1790344430 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | OTHA MYLES Medical Director 443-812-1889 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine |
| Additional Taxonomies | 207RI0200X Internal Medicine, Infectious Disease |
| Enumeration Date | 2019-06-06 |
| Last Update Date | 2022-01-11 |