| NPI | 1982962692 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | NATHANIEL SUMILANG Physician/Owner 410-272-3377 |
| Organization Subpart ? | No |
| Primary Taxonomy | 208000000X Pediatrics (Licence: MD D0059126) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: MD M38486) |
| Enumeration Date | 2012-05-01 |
| Last Update Date | 2012-05-01 |