| NPI | 1467828822 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | NADIA ISLAM Clinical Director 866-740-6502 |
| Organization Subpart ? | No |
| Primary Taxonomy | 390200000X Student in an Organized Health Care Education/Training Program |
| Enumeration Date | 2015-08-19 |
| Last Update Date | 2015-08-19 |