| NPI | 1700650199 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SAMANTHA MIHM Office Manager/Credentialing Spec 410-744-0661 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family |
| Enumeration Date | 2023-11-07 |
| Last Update Date | 2024-05-14 |