| NPI | 1538993001 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TARIQ DASTAGIR Owner 570-205-8125 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207PH0002X Emergency Medicine, Hospice and Palliative Medicine |
| Additional Taxonomies | 207R00000X Internal Medicine |
| 208100000X Physical Medicine & Rehabilitation | |
| Enumeration Date | 2024-08-28 |
| Last Update Date | 2026-07-09 |