| NPI | 1942499181 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KIMBLEY IEASHA GREEN Office Manager 410-532-4540 |
| Organization Subpart ? | No |
| Primary Taxonomy | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: MD D0038957) |
| Enumeration Date | 2007-10-23 |
| Last Update Date | 2007-10-26 |