| NPI | 1174198360 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | FRANK BRIAN SOUZA Owner 315-507-1344 |
| Organization Subpart ? | No |
| Primary Taxonomy | 163WR0006X Registered Nurse, Registered Nurse First Assistant |
| Enumeration Date | 2021-05-21 |
| Last Update Date | 2021-05-21 |