| NPI | 1619380979 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SELINA XING Owner/Physian 302-384-7439 |
| Organization Subpart ? | No |
| Primary Taxonomy | 332900000X Non-Pharmacy Dispensing Site (Licence: DE c10006679) |
| Enumeration Date | 2014-06-04 |
| Last Update Date | 2014-06-04 |