| NPI | 1184931230 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | FARID SADR President 712-308-1563 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QP2300X Clinic/Center, Primary Care (Licence: IA 34150) |
| Enumeration Date | 2010-09-10 |
| Last Update Date | 2014-10-31 |