| NPI | 1033732151 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LIZ SCRIVEN Credentialing 209-409-2585 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207XS0117X Orthopaedic Surgery, Orthopaedic Surgery of the Spine |
| Enumeration Date | 2020-05-22 |
| Last Update Date | 2020-09-02 |