| 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 |