| NPI | 1093325458 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | RAZEE AMEIR AHMAD Owner 601-917-0810 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QH0100X Clinic/Center, Health Services |
| Additional Taxonomies | 207Q00000X Family Medicine |
| Enumeration Date | 2020-07-31 |
| Last Update Date | 2020-08-04 |