| NPI | 1417365172 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | RICHARD O LARA Csfa/Cst 210-997-2188 |
| Organization Subpart ? | No |
| Primary Taxonomy | 246ZC0007X Specialist/Technologist, Other, Surgical Assistant (Licence: TX 101961) |
| Enumeration Date | 2014-07-25 |
| Last Update Date | 2015-01-12 |