| NPI | 1053782813 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TAKINA WILSON Chief Operating Officer 410-591-4273 |
| Organization Subpart ? | No |
| Primary Taxonomy | 174400000X Specialist |
| Additional Taxonomies | 207VG0400X Obstetrics & Gynecology, Gynecology |
| 261QF0050X Clinic/Center, Family Planning, Non-Surgical | |
| 363L00000X Nurse Practitioner | |
| Enumeration Date | 2015-10-19 |
| Last Update Date | 2025-04-03 |