NPI | 1467076059 |
---|---|
Entity Type | Organization |
Authorized Contact | LOUIS E COSTA Owner 302-505-0045 |
Organization Subpart ? | No |
Primary Taxonomy | 208600000X Surgery |
Additional Taxonomies | 261QM2500X Clinic/Center, Medical Specialty |
Enumeration Date | 2020-05-30 |
Last Update Date | 2020-07-15 |