| NPI | 1689063232 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | WILLIAM JERNBERG President 469-401-2386 |
| Organization Subpart ? | No |
| Primary Taxonomy | 208600000X Surgery |
| Additional Taxonomies | 2086S0127X Surgery Trauma Surgery |
| Enumeration Date | 2015-01-21 |
| Last Update Date | 2015-01-21 |