| NPI | 1063992733 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MOHAMMED AKHLACK HOSSAIN MAZUMDER President 606-874-0112 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363LP2300X Nurse Practitioner, Primary Care |
| Enumeration Date | 2018-08-21 |
| Last Update Date | 2018-08-21 |