NPI | 1154988822 |
---|---|
Entity Type | Organization |
Authorized Contact | JAMES PARK Member 410-834-3274 |
Organization Subpart ? | No |
Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health |
Additional Taxonomies | 2084P0800X Psychiatry & Neurology, Psychiatry |
Enumeration Date | 2019-05-28 |
Last Update Date | 2019-05-28 |