NPI | 1285300574 |
---|---|
Entity Type | Organization |
Authorized Contact | MALIK SHEHROZ Credentialing Specialist 410-403-0544 |
Organization Subpart ? | No |
Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health |
Enumeration Date | 2021-08-18 |
Last Update Date | 2022-03-25 |