| NPI | 1235876392 |
|---|---|
| Former Legal Business Name | N/A |
| Entity Type | Organization |
| Authorized Contact | GEORGIA CHIAMBA CEO 443-762-6390 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family |
| Enumeration Date | 2022-05-19 |
| Last Update Date | 2024-07-16 |