| NPI | 1306419346 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JESSICA LI Administrator 330-987-6098 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine |
| Additional Taxonomies | 291U00000X Clinical Medical Laboratory |
| 207R00000X Internal Medicine | |
| Enumeration Date | 2021-07-19 |
| Last Update Date | 2026-04-26 |