| NPI | 1578159083 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SAMUEL LOERA DIAZ Licensed Surgical Assistant 909-659-9388 |
| Organization Subpart ? | No |
| Primary Taxonomy | 246ZC0007X Specialist/Technologist, Other, Surgical Assistant |
| Enumeration Date | 2020-12-18 |
| Last Update Date | 2022-10-11 |