| NPI | 1164863718 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DANIEL GURULE President 747-224-0072 |
| Organization Subpart ? | No |
| Primary Taxonomy | 302F00000X Exclusive Provider Organization (Licence: CA 501C3) |
| Enumeration Date | 2013-07-11 |
| Last Update Date | 2013-07-11 |