| NPI | 1710152194 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MARSHA K DIMITROFF Owner 713-465-4106 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363AM0700X Physician Assistant, Medical |
| Additional Taxonomies | 363AS0400X Physician Assistant, Surgical |
| Enumeration Date | 2008-04-25 |
| Last Update Date | 2008-04-25 |