| NPI | 1043884273 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | YU GUO Director Of The Clinic 669-298-7989 |
| Organization Subpart ? | No |
| Primary Taxonomy | 390200000X Student in an Organized Health Care Education/Training Program |
| Enumeration Date | 2021-05-13 |
| Last Update Date | 2023-06-13 |