| NPI | 1740049568 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KRYSTLE BROWN Billing Manager 410-870-9380 |
| Organization Subpart ? | No |
| Primary Taxonomy | 208VP0000X Pain Medicine, Pain Medicine |
| Additional Taxonomies | 363LP0808X Nurse Practitioner, Psych/Mental Health |
| Enumeration Date | 2024-03-14 |
| Last Update Date | 2024-07-25 |