Individual
KENNY BARAJAS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
14721 TRIADELPHIA RD, GLENELG, MD 21737-9409
(443) 266-7029
Mailing address
14721 TRIADELPHIA RD, GLENELG, MD 21737-9409
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
R134988
MD
Other
Enumeration date
01/12/2007
Last updated
07/08/2007
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