| NPI | 1013348028 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KEITH D PERSINGER Chief Operating Officer 443-275-9800 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner |
| Additional Taxonomies | 207Q00000X Family Medicine |
| Enumeration Date | 2013-12-02 |
| Last Update Date | 2025-07-29 |