| NPI | 1447635453 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ROXANNA LAROQUE Director Of Client Experienc 210-598-2801 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363AS0400X Physician Assistant Surgical |
| Enumeration Date | 2015-07-21 |
| Last Update Date | 2022-06-10 |