| NPI | 1942768528 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | RAVIKUMAR BHALAVAT President 410-670-3076 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health |
| Enumeration Date | 2019-03-04 |
| Last Update Date | 2019-06-07 |