| NPI | 1154993350 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SUNNY B DIFFANG Owner Of Entity 410-528-3866 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health |
| Enumeration Date | 2021-07-15 |
| Last Update Date | 2021-08-05 |