| NPI | 1699570465 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | YURY MALACHEVSKY Practice Owner 443-845-4458 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363LP2300X Nurse Practitioner Primary Care |
| Additional Taxonomies | 363LP0808X Nurse Practitioner Psychiatric/Mental Health |
| Enumeration Date | 2025-02-17 |
| Last Update Date | 2025-02-17 |