| NPI | 1720620313 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JANISSA GUTIERREZ Director Of Operations 866-344-2692 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207WX0107X Ophthalmology, Retina Specialist |
| Additional Taxonomies | 156F00000X Technician/Technologist |
| Enumeration Date | 2019-10-15 |
| Last Update Date | 2023-04-24 |