| NPI | 1467189761 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | HEEWA FARAJ Owner/Authorized Official 267-399-9102 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QP2300X Clinic/Center, Primary Care |
| Additional Taxonomies | 207R00000X Internal Medicine |
| Enumeration Date | 2022-08-05 |
| Last Update Date | 2024-03-29 |