| NPI | 1417792599 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | WESAM MOUSTAFA HUSSEIN Md 346-220-3534 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine |
| Additional Taxonomies | 261QP2300X Clinic/Center, Primary Care |
| Enumeration Date | 2024-06-28 |
| Last Update Date | 2024-08-19 |