| NPI | 1952540635 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SRILATHA KANUMURU Owner 410-719-0020 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QC1500X Clinic/Center, Community Health (Licence: MD D0064539) |
| Enumeration Date | 2009-02-19 |
| Last Update Date | 2009-02-19 |