| NPI | 1164211025 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | RADA PAVENKO Owner 678-200-2903 |
| Organization Subpart ? | No |
| Primary Taxonomy | 246ZC0007X Specialist/Technologist, Other, Surgical Assistant |
| Enumeration Date | 2025-05-06 |
| Last Update Date | 2025-05-06 |