| NPI | 1801180104 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JENNAH HUONG THI LE Account Director 408-440-2359 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363AS0400X Physician Assistant, Surgical |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery |
| 208600000X Surgery | |
| 363A00000X Physician Assistant | |
| Enumeration Date | 2011-06-03 |
| Last Update Date | 2021-11-29 |