| NPI | 1790457752 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LUIS MIGNUCCI President 972-378-6908 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 204C00000X Neuromusculoskeletal Medicine, Sports Medicine |
| Enumeration Date | 2021-09-29 |
| Last Update Date | 2021-09-29 |