| NPI | 1891470142 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SHAKEISHA JARVIS-DRAKE Nurse Practitioner 410-805-3781 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 363LP2300X Nurse Practitioner, Primary Care |
| Enumeration Date | 2023-06-15 |
| Last Update Date | 2023-06-15 |