| NPI | 1376936823 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | PATRICIA A GATES Credentialing Specialist 410-535-7068 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363LG0600X Nurse Practitioner, Gerontology (Licence: MD R144667) |
| Enumeration Date | 2015-03-09 |
| Last Update Date | 2015-03-09 |