| NPI | 1083587612 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JEREMY M STAFFORD Csfa 915-433-3922 |
| Organization Subpart ? | No |
| Primary Taxonomy | 246ZC0007X Specialist/Technologist, Other, Surgical Assistant |
| Enumeration Date | 2025-09-29 |
| Last Update Date | 2025-09-29 |