| NPI | 1407406440 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | PETREL MARTIN-HALL Nurse Practitioner/Pcp 410-329-4818 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family |
| Enumeration Date | 2019-09-11 |
| Last Update Date | 2020-01-31 |