| NPI | 1962211953 |
|---|---|
| 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 | 2025-01-03 |
| Last Update Date | 2025-01-03 |