NPI | 1336170257 |
---|---|
Entity Type | Organization |
Authorized Contact | DRAKE ERIC BELLANGER Owner 225-819-0983 |
Organization Subpart ? | No |
Primary Taxonomy | 208600000X Surgery (Licence: LA 11666R) |
Additional Taxonomies | 208600000X Surgery (Licence: AL 00017405) |
Enumeration Date | 2006-07-06 |
Last Update Date | 2020-08-22 |