| NPI | 1831703677 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DIA LYNAE JOHNSON Nurse Practitioner 443-558-8532 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363LP2300X Nurse Practitioner, Primary Care |
| Enumeration Date | 2020-08-31 |
| Last Update Date | 2020-08-31 |