| NPI | 1093558611 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SUSAN IBRAHIM Owner 901-857-4228 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QP2300X Clinic/Center, Primary Care |
| Additional Taxonomies | 207Q00000X Family Medicine |
| Enumeration Date | 2024-06-13 |
| Last Update Date | 2025-05-09 |