| NPI | 1124386065 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MARK LAYSHOCK President 410-422-4263 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363LA2200X Nurse Practitioner, Adult Health (Licence: MD R041641) |
| Enumeration Date | 2012-04-29 |
| Last Update Date | 2012-08-02 |