| NPI | 1053189126 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ENNISS HERNANDEZ MATIAS Owner/Administrator 939-366-8190 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QH0100X Clinic/Center, Health Services |
| Enumeration Date | 2023-12-18 |
| Last Update Date | 2023-12-18 |