| NPI | 1043564529 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | YOUSRY GIRGIS President 331-425-2374 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QP2300X Clinic/Center, Primary Care (Licence: IL 036.129213) |
| Enumeration Date | 2012-11-05 |
| Last Update Date | 2019-07-16 |