| NPI | 1417781253 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MICHAEL MUGO Authorized Official 443-835-8678 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363LP0808X Nurse Practitioner Psychiatric/Mental Health |
| Enumeration Date | 2024-08-26 |
| Last Update Date | 2024-09-12 |