| NPI | 1558497040 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LIZA DE OLAZO BANAAG Owner 832-646-5492 |
| Organization Subpart ? | No |
| Primary Taxonomy | 2083P0011X Preventive Medicine, Undersea and Hyperbaric Medicine (Licence: MS 19748) |
| Enumeration Date | 2007-02-26 |
| Last Update Date | 2008-01-25 |