| NPI | 1720332190 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MOUSTAFA ALI Medical Director/Owner 508-679-0911 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QA1903X Clinic/Center, Ambulatory Surgical |
| Enumeration Date | 2012-11-06 |
| Last Update Date | 2012-11-06 |