| NPI | 1730745928 |
|---|---|
| Doing Business As | ETSUB NEGUSSIE HAILESELASSIE |
| Entity Type | Organization |
| Authorized Contact | ETSUB NEGUSSIE HAILESELASSIE Owner 469-269-7259 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QR0208X Clinic/Center, Radiology, Mobile |
| Enumeration Date | 2019-05-14 |
| Last Update Date | 2019-05-14 |