| NPI | 1851910855 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SANDRA FERGUSON Executive Director 443-717-3477 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine |
| Additional Taxonomies | 163W00000X Registered Nurse |
| 207R00000X Internal Medicine | |
| Enumeration Date | 2020-04-10 |
| Last Update Date | 2023-10-29 |