| NPI | 1003322108 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SEBHATU GEBREZGI Owner 718-272-0977 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine |
| Additional Taxonomies | 173000000X Legal Medicine |
| Enumeration Date | 2017-12-27 |
| Last Update Date | 2017-12-27 |