| NPI | 1164654471 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SHABANA C KARIM Owner 662-332-8848 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QP2300X Clinic/Center, Primary Care (Licence: MS 19663) |
| Enumeration Date | 2009-08-20 |
| Last Update Date | 2010-03-05 |