| NPI | 1609513639 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MARIANO DE SOCARRAZ CEO 866-333-4752 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QP2300X Clinic/Center Primary Care |
| Additional Taxonomies | 2083X0100X Preventive Medicine Occupational Medicine |
| Enumeration Date | 2022-05-20 |
| Last Update Date | 2022-05-20 |