| NPI | 1114523495 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JESSICA ELIZABETH HOLMES Nurse Practicioner 443-554-6173 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QP2300X Clinic/Center, Primary Care |
| Enumeration Date | 2020-12-10 |
| Last Update Date | 2020-12-10 |