| NPI | 1912245242 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | NATASHA A. SANDY President 443-255-7089 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207N00000X Dermatology |
| Additional Taxonomies | 207Q00000X Family Medicine |
| Enumeration Date | 2013-01-22 |
| Last Update Date | 2020-01-22 |