| NPI | 1013677517 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | VICENTE BARCES Lsa 346-297-5468 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363AS0400X Physician Assistant, Surgical |
| Additional Taxonomies | 363A00000X Physician Assistant |
| Enumeration Date | 2021-12-23 |
| Last Update Date | 2021-12-27 |