| NPI | 1962359679 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | BAKARI CHAKHMAKHASHVILI President 443-883-8634 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QA1903X Clinic/Center, Ambulatory Surgical |
| Enumeration Date | 2026-03-12 |
| Last Update Date | 2026-03-12 |