| NPI | 1194742288 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | RAUL NELSON LUGO President 864-580-8033 |
| Organization Subpart ? | No |
| Primary Taxonomy | 2086X0206X Surgery Surgical Oncology |
| Additional Taxonomies | 174400000X Specialist (Licence: SC 27417) |
| Enumeration Date | 2006-07-16 |
| Last Update Date | 2019-10-29 |