| NPI | 1821286766 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | NASSER NASSERI President 410-744-0661 |
| Organization Subpart ? | No |
| Primary Taxonomy | 174400000X Specialist (Licence: MD d60914) |
| Additional Taxonomies | 332900000X Non-Pharmacy Dispensing Site |
| Enumeration Date | 2007-10-04 |
| Last Update Date | 2024-12-06 |