| NPI | 1780165308 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TRACY CHINITA BISHOP Owner 410-356-4680 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: MD r154217) |
| Enumeration Date | 2018-08-22 |
| Last Update Date | 2023-05-16 |