| NPI | 1922806892 | 
|---|---|
| Entity Type | Organization | 
| Authorized Contact | LISA BADIE Vice President Finance 443-923-1812  | 
| Organization Subpart ? | Yes | 
| Primary Taxonomy | 208000000X Pediatrics | 
| Additional Taxonomies | 261QM1300X Clinic/Center, Multi-Specialty | 
| Enumeration Date | 2025-03-05 | 
| Last Update Date | 2025-03-05 |