| NPI | 1467759357 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DAMON CHARLES FRACH Office Manager 408-984-2455 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363AS0400X Physician Assistant, Surgical |
| Additional Taxonomies | 363AM0700X Physician Assistant, Medical |
| Enumeration Date | 2011-02-11 |
| Last Update Date | 2011-04-06 |