| 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 |