| NPI | 1871032409 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SHARON K BOOZE Practice Manager 410-820-5945 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363LA2200X Nurse Practitioner Adult Health (Licence: MD AC000387) |
| Enumeration Date | 2017-02-15 |
| Last Update Date | 2017-02-15 |