| NPI | 1124857552 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LENART EMILIO VEGA LEYVA Physician 346-537-8540 |
| Organization Subpart ? | No |
| Primary Taxonomy | 208100000X Physical Medicine & Rehabilitation |
| Enumeration Date | 2024-08-01 |
| Last Update Date | 2024-08-01 |