| NPI | 1023356144 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | IRINA M JOUKOVA Owner 267-307-9236 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207RC0000X Internal Medicine, Cardiovascular Disease (Licence: PA MD435017) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: PA MD435017) |
| 207RC0000X Internal Medicine, Cardiovascular Disease (Licence: NJ 25MA08508800) | |
| Enumeration Date | 2013-01-24 |
| Last Update Date | 2013-03-28 |