| NPI | 1669912259 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | BAMOYO NKONGOLO Owner 302-562-9437 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QP2300X Clinic/Center, Primary Care (Licence: MD C03263) |
| Enumeration Date | 2017-03-01 |
| Last Update Date | 2017-03-01 |