| NPI | 1093477655 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JOSE LUIS GUZMAN Statutory Agent 480-834-6810 |
| Organization Subpart ? | No |
| Primary Taxonomy | 246ZC0007X Specialist/Technologist, Other, Surgical Assistant |
| Enumeration Date | 2021-10-12 |
| Last Update Date | 2021-10-12 |