| NPI | 1770265365 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | VINCENT UZEGBULEM EZEDIKE Nurse Practitioner 410-916-4825 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health |
| Enumeration Date | 2023-08-02 |
| Last Update Date | 2023-08-02 |