| NPI | 1033787239 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SIRAJ K AHMED Owner 209-823-2131 |
| Organization Subpart ? | No |
| Primary Taxonomy | 2083P0011X Preventive Medicine Undersea and Hyperbaric Medicine |
| Enumeration Date | 2021-06-14 |
| Last Update Date | 2022-04-12 |