NPI | 1184049561 |
---|---|
Entity Type | Organization |
Authorized Contact | SHAWN XUN MEI Owner 228-284-1642 |
Organization Subpart ? | No |
Primary Taxonomy | 305S00000X Point of Service (Licence: MS 18456) |
Additional Taxonomies | 305S00000X Point of Service (Licence: MS BM8022149) |
Enumeration Date | 2014-02-21 |
Last Update Date | 2014-02-21 |