| NPI | 1710345848 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KAYLIN PENA Csfa/Cst Owner 678-315-8501 |
| Organization Subpart ? | No |
| Primary Taxonomy | 246ZC0007X Specialist/Technologist, Other, Surgical Assistant |
| Enumeration Date | 2016-02-03 |
| Last Update Date | 2016-12-08 |