| NPI | 1780447581 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JUVEL-LOU P VELASCO Nurse Practitioner 443-791-7069 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner |
| Additional Taxonomies | 261Q00000X Clinic/Center |
| Enumeration Date | 2024-02-05 |
| Last Update Date | 2025-05-02 |