| NPI | 1629772488 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | GINA BACCARI Authorized Official 210-602-0370 |
| Organization Subpart ? | No |
| Primary Taxonomy | 208600000X Surgery |
| Additional Taxonomies | 225500000X Specialist/Technologist |
| 363AS0400X Physician Assistant, Surgical | |
| Enumeration Date | 2023-03-28 |
| Last Update Date | 2023-03-28 |