| NPI | 1164040200 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SAMANTHA ROBERTA KITE Owner 443-204-2421 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family |
| Additional Taxonomies | 363LA2200X Nurse Practitioner, Adult Health |
| Enumeration Date | 2020-07-06 |
| Last Update Date | 2020-11-11 |