| NPI | 1730968173 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | NASIRA MAH-JABEEN Credentialing Agent 150-257-9017 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM1300X Clinic/Center, Multi-Specialty |
| Enumeration Date | 2023-09-25 |
| Last Update Date | 2023-09-25 |