| NPI | 1932819836 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | QING GE Medical Director 386-788-6198 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QA1903X Clinic/Center, Ambulatory Surgical |
| Additional Taxonomies | 261QS0132X Clinic/Center, Ophthalmologic Surgery |
| Enumeration Date | 2022-12-01 |
| Last Update Date | 2023-08-22 |