| NPI | 1063147395 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MEGAN GREY Owner 410-995-7439 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine |
| Additional Taxonomies | 363LA2200X Nurse Practitioner, Adult Health |
| Enumeration Date | 2022-07-20 |
| Last Update Date | 2023-07-25 |