| NPI | 1366141590 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KYRRA GRIFFIS Cst, Csfa 308-379-6727 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363AS0400X Physician Assistant, Surgical |
| Additional Taxonomies | 246ZC0007X Specialist/Technologist, Other, Surgical Assistant |
| Enumeration Date | 2023-02-27 |
| Last Update Date | 2023-06-11 |