| NPI | 1851128599 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ALANA MARIE O'NEILL President/Owner 410-823-5357 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner Family |
| Additional Taxonomies | 261QM2500X Clinic/Center Medical Specialty |
| 261Q00000X Clinic/Center | |
| 261QM1300X Clinic/Center Multi-Specialty | |
| Enumeration Date | 2024-09-17 |
| Last Update Date | 2024-09-17 |