| NPI | 1376226969 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | BRIAN DYNELL WEST-PEARSON Nurse Practitioner 443-902-1364 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261Q00000X Clinic/Center |
| Additional Taxonomies | 363L00000X Nurse Practitioner |
| 363LF0000X Nurse Practitioner, Family | |
| 363LP0808X Nurse Practitioner, Psych/Mental Health | |
| Enumeration Date | 2023-08-09 |
| Last Update Date | 2024-11-02 |