| NPI | 1518401546 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | RICARDO PEVERINI President 909-558-2480 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207T00000X Neurological Surgery |
| Additional Taxonomies | 363A00000X Physician Assistant |
| 363L00000X Nurse Practitioner | |
| Enumeration Date | 2016-12-09 |
| Last Update Date | 2019-07-19 |