| NPI | 1861577645 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | REGINA KIRWAN WARDWELL Nurse Practitioner 410-887-4456 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261Q00000X Clinic/Center (Licence: MD R121844) |
| Enumeration Date | 2006-10-27 |
| Last Update Date | 2020-08-22 |