| NPI | 1104778638 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KETEVANI SHAVLIASHVILI Founder & CEO 347-733-3709 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM2500X Clinic/Center, Medical Specialty |
| Enumeration Date | 2026-02-09 |
| Last Update Date | 2026-02-09 |