| NPI | 1114166014 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ABDIAS D ETIENNE President 917-204-6110 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QH0100X Clinic/Center, Health Services (Licence: TX N1626) |
| Enumeration Date | 2009-02-17 |
| Last Update Date | 2012-03-30 |