| NPI | 1982149555 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | AMY M LUEBEHUSEN Family Nurse Practitioner 410-961-6578 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QP2300X Clinic/Center, Primary Care (Licence: MD R172676) |
| Enumeration Date | 2017-01-05 |
| Last Update Date | 2017-01-05 |