| NPI | 1154636686 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LUIS CARLOS GONZALEZ Owner 814-362-4345 |
| Organization Subpart ? | No |
| Primary Taxonomy | 208600000X Surgery (Licence: PA MD0549041) |
| Additional Taxonomies | 363AS0400X Physician Assistant, Surgical (Licence: PA 363AS0400x) |
| Enumeration Date | 2010-08-09 |
| Last Update Date | 2010-08-09 |