| NPI | 1275100133 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | AMBERLEE MORE Csfa 307-220-1112 |
| Organization Subpart ? | No |
| Primary Taxonomy | 246ZC0007X Specialist/Technologist, Other, Surgical Assistant |
| Enumeration Date | 2021-06-09 |
| Last Update Date | 2022-03-18 |