| NPI | 1699388710 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | RADOSLAW STEFAN KIESZ President 210-802-4350 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261Q00000X |
| Additional Taxonomies | 208600000X Surgery |
| 261QA1903X Clinic/Center, Ambulatory Surgical | |
| Enumeration Date | 2020-08-28 |
| Last Update Date | 2020-11-30 |