| NPI | 1609000546 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | PATRICK ESKANDAR Owner 228-865-4731 |
| Organization Subpart ? | No |
| Primary Taxonomy | 174400000X Specialist (Licence: MS 18381) |
| Additional Taxonomies | 174400000X Specialist (Licence: MS 17733) |
| 174400000X Specialist (Licence: MS 07091) | |
| 174400000X Specialist (Licence: MS 12692) | |
| Enumeration Date | 2009-05-06 |
| Last Update Date | 2009-05-06 |