| NPI | 1265069488 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TYWANNA HAMILTON Medical Director/Nurse Practitioner 410-855-4448 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family |
| Enumeration Date | 2020-03-26 |
| Last Update Date | 2020-04-13 |