| NPI | 1376377515 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MITSI LISET GUTIERREZ RAMAL Practice Owner 484-860-0407 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QP2300X Clinic/Center, Primary Care |
| Enumeration Date | 2024-08-29 |
| Last Update Date | 2024-08-29 |