| NPI | 1811389976 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JAIME GABRIEL GUTIERREZ Owner/President 917-678-0079 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QA1903X Clinic/Center, Ambulatory Surgical |
| Enumeration Date | 2015-02-26 |
| Last Update Date | 2015-02-26 |