| NPI | 1508919523 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LUTGARDA CRUZ TOLENTINO Owner 440-888-7922 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: OH 35039846-T) |
| Enumeration Date | 2007-01-21 |
| Last Update Date | 2012-02-28 |