| NPI | 1245977511 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ERIC GENE VALLES Csfa/Lsa 325-212-6975 |
| Organization Subpart ? | No |
| Primary Taxonomy | 246ZC0007X Specialist/Technologist, Other, Surgical Assistant |
| Enumeration Date | 2022-05-17 |
| Last Update Date | 2022-05-17 |