| NPI | 1285225698 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | AMANDA ERWIN Owner 985-960-7080 |
| Organization Subpart ? | No |
| Primary Taxonomy | 246ZC0007X Specialist/Technologist, Other, Surgical Assistant |
| Enumeration Date | 2021-01-28 |
| Last Update Date | 2021-01-28 |