| NPI | 1811142771 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | BENJAMIN LEE Owner 443-484-2828 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QA1903X Clinic/Center, Ambulatory Surgical (Licence: MD W11478880) |
| Enumeration Date | 2008-11-19 |
| Last Update Date | 2010-08-27 |