| NPI | 1861083594 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | IBRAHIM KAMAL Authorized Official 877-589-1424 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261Q00000X Clinic/Center |
| Additional Taxonomies | 261QM1300X Clinic/Center, Multi-Specialty |
| 261QR0208X Clinic/Center, Radiology, Mobile | |
| Enumeration Date | 2021-01-26 |
| Last Update Date | 2022-03-28 |