NPI | 1518654268 |
---|---|
Entity Type | Organization |
Authorized Contact | IFEYINWA IBEANU Medical Director 443-969-2310 |
Organization Subpart ? | Yes |
Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health |
Enumeration Date | 2023-04-21 |
Last Update Date | 2023-04-21 |