| NPI | 1477988681 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | OVIE APPRESAI Managing Employee 681-318-3501 |
| Organization Subpart ? | No |
| Primary Taxonomy | 2086S0129X (Licence: WV 24660) |
| Additional Taxonomies | 208600000X Surgery (Licence: WV 24460) |
| Enumeration Date | 2013-09-06 |
| Last Update Date | 2017-07-11 |