| NPI | 1962273698 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LISA S TUBMAN Psychiatric Nurse Practitioner 443-480-7510 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health |
| Enumeration Date | 2024-01-11 |
| Last Update Date | 2024-01-11 |