| NPI | 1558066092 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | VIVIAN D GOODMAN Surgicel First Assistant 214-455-1901 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363AS0400X Physician Assistant, Surgical |
| Enumeration Date | 2023-04-04 |
| Last Update Date | 2023-10-26 |