| NPI | 1093554024 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LISA R ST JOHN Authorized Official 408-800-0195 |
| Organization Subpart ? | No |
| Primary Taxonomy | 2083P0011X Preventive Medicine, Undersea and Hyperbaric Medicine |
| Enumeration Date | 2024-05-20 |
| Last Update Date | 2024-06-18 |