| NPI | 1033824032 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LINDSY M VARGAS GUEVARA Owner 678-294-9735 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363AS0400X Physician Assistant, Surgical |
| Additional Taxonomies | 246ZC0007X Specialist/Technologist, Other, Surgical Assistant |
| Enumeration Date | 2023-01-16 |
| Last Update Date | 2024-11-09 |