NPI | 1730892035 |
---|---|
Entity Type | Organization |
Authorized Contact | TRAVIS A BAIRD Owner 443-430-2998 |
Organization Subpart ? | No |
Primary Taxonomy | 207QA0401X Family Medicine, Addiction Medicine |
Additional Taxonomies | 363LA2200X Nurse Practitioner, Adult Health |
Enumeration Date | 2023-01-02 |
Last Update Date | 2023-05-19 |