| NPI | 1346964178 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CORINA SIORDIA Surgical Assistant Certified 505-304-5165 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363AS0400X Physician Assistant, Surgical |
| Enumeration Date | 2022-09-26 |
| Last Update Date | 2022-09-29 |