| NPI | 1346821881 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SARAH CANNON Owner 469-826-4723 |
| Organization Subpart ? | No |
| Primary Taxonomy | 246ZC0007X Specialist/Technologist, Other, Surgical Assistant |
| Enumeration Date | 2021-04-16 |
| Last Update Date | 2021-04-16 |