| NPI | 1508014697 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ROBERT WAYNE TAHARA President 814-368-8490 |
| Organization Subpart ? | No |
| Primary Taxonomy | 2086S0129X (Licence: PA MD419351) |
| Additional Taxonomies | 208600000X Surgery (Licence: PA MD419351) |
| Enumeration Date | 2008-09-03 |
| Last Update Date | 2016-03-23 |