| NPI | 1255171864 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SHELLEE LAZAR Authorized Rep 909-709-6826 |
| Organization Subpart ? | No |
| Primary Taxonomy | 2083P0011X Preventive Medicine, Undersea and Hyperbaric Medicine |
| Enumeration Date | 2024-05-30 |
| Last Update Date | 2024-05-30 |