| NPI | 1609884592 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | NELIDA R ENRIQUE President Treasurer 216-271-1947 |
| Organization Subpart ? | No |
| Primary Taxonomy | 208D00000X General Practice (Licence: OH 35033404) |
| Enumeration Date | 2006-08-04 |
| Last Update Date | 2010-02-22 |