| NPI | 1093443426 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ISLAM ABOUMOUSSA Provider 929-301-2437 |
| Organization Subpart ? | No |
| Primary Taxonomy | 390200000X Student in an Organized Health Care Education/Training Program |
| Enumeration Date | 2022-08-12 |
| Last Update Date | 2024-04-20 |