| NPI | 1467240382 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ALEXANDER GHATAN Medical Director 855-786-7846 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QA1903X Clinic/Center, Ambulatory Surgical |
| Enumeration Date | 2025-04-29 |
| Last Update Date | 2025-08-22 |