| NPI | 1205538535 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | OLEG LUSHER President 754-255-1500 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM2500X Clinic/Center Medical Specialty |
| Additional Taxonomies | 261QR1100X Clinic/Center Research |
| Enumeration Date | 2023-03-20 |
| Last Update Date | 2025-06-12 |