| NPI | 1962011288 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | WILLIAM SHAFFER Director/Owner 443-559-4137 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family |
| Additional Taxonomies | 363L00000X Nurse Practitioner |
| Enumeration Date | 2020-07-23 |
| Last Update Date | 2023-04-04 |