| NPI | 1891380432 | 
|---|---|
| Entity Type | Organization | 
| Authorized Contact | NICOLAS SHAMMAS Owner 563-320-0263  | 
| Organization Subpart ? | No | 
| Primary Taxonomy | 207RC0000X Internal Medicine, Cardiovascular Disease | 
| Additional Taxonomies | 261QM2500X Clinic/Center, Medical Specialty | 
| Enumeration Date | 2021-03-05 | 
| Last Update Date | 2021-03-05 |