| NPI | 1891766283 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JOHN P KNUD HANSEN Authorized Official Vice President 410-822-5552 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM1300X Clinic/Center, Multi-Specialty |
| Enumeration Date | 2006-02-01 |
| Last Update Date | 2020-08-22 |