| NPI | 1750197661 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CHRISTIE SIMON-WATERMAN Owner 443-883-1826 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family |
| Additional Taxonomies | 251S00000X |
| 261QP2300X Clinic/Center, Primary Care | |
| Enumeration Date | 2024-12-05 |
| Last Update Date | 2024-12-05 |