| NPI | 1275134934 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | VICTORIA AJAYI Provider 443-538-1383 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family |
| Additional Taxonomies | 207QA0401X Family Medicine, Addiction Medicine |
| 363LP2300X Nurse Practitioner, Primary Care | |
| Enumeration Date | 2020-11-07 |
| Last Update Date | 2021-08-02 |