| NPI | 1750773727 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | PABLO J BASSUK Owner/Authorized Official 747-273-1129 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: CA A99057) |
| Enumeration Date | 2015-02-26 |
| Last Update Date | 2023-04-19 |