| NPI | 1124693015 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TRISHA-LEIGH PORTER Owner/Np 443-379-4410 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family |
| Additional Taxonomies | 363LP2300X Nurse Practitioner, Primary Care |
| Enumeration Date | 2021-05-24 |
| Last Update Date | 2021-07-02 |