| NPI | 1205005840 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TEIMOURAZ V VASSILIDZE Anesthesiologist/ Member 732-850-0132 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QA1903X Clinic/Center, Ambulatory Surgical (Licence: NJ 25MA06904200) |
| Enumeration Date | 2008-02-28 |
| Last Update Date | 2008-02-28 |