| NPI | 1952822561 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DEANNA DELOACH Credentialing 410-821-7775 |
| Organization Subpart ? | No |
| Primary Taxonomy | 2083T0002X Preventive Medicine, Medical Toxicology (Licence: MD 21D1100810) |
| Enumeration Date | 2017-07-05 |
| Last Update Date | 2022-07-21 |