| NPI | 1265487128 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | RODRIGO CORDERO TANCHANCO Owner 302-376-9888 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QP2300X Clinic/Center Primary Care (Licence: DE 2005202434) |
| Enumeration Date | 2006-05-22 |
| Last Update Date | 2020-08-22 |