| NPI | 1821079997 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LISA LARAY STANTON C RN P 410-601-2246 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363LG0600X Nurse Practitioner, Gerontology (Licence: MD R111052) |
| Enumeration Date | 2005-11-07 |
| Last Update Date | 2020-08-22 |