| NPI | 1841697463 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | WARREN LAURITA Administrator 216-831-4748 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: OH 50.002593) |
| Enumeration Date | 2014-11-25 |
| Last Update Date | 2014-11-25 |