| NPI | 1093991564 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | BASSAM MOUSHMOUSH Owner 304-419-0395 |
| Organization Subpart ? | No |
| Primary Taxonomy | 293D00000X Physiological Laboratory (Licence: WV 01010/4730849-01) |
| Enumeration Date | 2008-01-15 |
| Last Update Date | 2008-01-15 |