| NPI | 1528803863 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JACOB HA Owner/CEO 410-401-7575 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QP3300X Clinic/Center, Pain |
| Additional Taxonomies | 363LP2300X Nurse Practitioner, Primary Care |
| Enumeration Date | 2024-06-27 |
| Last Update Date | 2024-12-31 |