| NPI | 1538552922 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ENRIQUE RODRIGUEZ Owner 856-203-5655 |
| Organization Subpart ? | No |
| Primary Taxonomy | 246ZC0007X Specialist/Technologist, Other, Surgical Assistant (Licence: DC SA0118) |
| Additional Taxonomies | 363AS0400X Physician Assistant, Surgical |
| Enumeration Date | 2015-03-10 |
| Last Update Date | 2015-03-10 |