| NPI | 1467792457 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SAMEER GUPTA President CEO 800-955-8346 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM2500X Clinic/Center, Medical Specialty (Licence: WI 56238-020) |
| Additional Taxonomies | 261QM2500X Clinic/Center, Medical Specialty |
| Enumeration Date | 2013-02-27 |
| Last Update Date | 2014-05-20 |