| NPI | 1184277873 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | OTHONIEL NATHAN PINEDA Member 817-687-8014 |
| Organization Subpart ? | No |
| Primary Taxonomy | 2083P0011X Preventive Medicine, Undersea and Hyperbaric Medicine |
| Enumeration Date | 2019-07-22 |
| Last Update Date | 2019-07-22 |