| NPI | 1619148012 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SALEEM SAJID Owner 270-982-5138 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM2500X Clinic/Center, Medical Specialty (Licence: KY 36225) |
| Enumeration Date | 2008-03-13 |
| Last Update Date | 2022-07-21 |