NPI | 1285092734 |
---|---|
Entity Type | Organization |
Authorized Contact | LYSTRA EASTLYN WILLIAMS Nurse Practitioner 443-979-0302 |
Organization Subpart ? | No |
Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: MD R132674) |
Enumeration Date | 2016-01-29 |
Last Update Date | 2019-08-18 |