| NPI | 1083490619 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SAN LAZARO CARNERO Manager 702-969-9755 |
| Organization Subpart ? | No |
| Primary Taxonomy | 332B00000X Durable Medical Equipment & Medical Supplies |
| Enumeration Date | 2023-09-08 |
| Last Update Date | 2023-09-11 |