| NPI | 1104446467 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SURESH RAJAMANICKAM Direct Owner 561-767-0721 |
| Organization Subpart ? | No |
| Primary Taxonomy | 174400000X Specialist |
| Additional Taxonomies | 261QR1100X Clinic/Center, Research |
| Enumeration Date | 2020-04-16 |
| Last Update Date | 2023-08-28 |