| 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 |