| NPI | 1447520572 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DONNELLE J DUBOIS Director 408-440-2359 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery |
| 363AS0400X Physician Assistant Surgical | |
| Enumeration Date | 2012-01-05 |
| Last Update Date | 2012-01-16 |