| NPI | 1962768655 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KERRY COLLEEN PALAKANIS Owner 443-493-0062 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: MD R105366) |
| Enumeration Date | 2012-04-06 |
| Last Update Date | 2012-04-06 |