| NPI | 1821492125 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KIM GRETHER SALLOUX Owner 415-845-7288 |
| Organization Subpart ? | No |
| Primary Taxonomy | 305R00000X Preferred Provider Organization (Licence: MT 32222) |
| Enumeration Date | 2014-10-15 |
| Last Update Date | 2014-10-15 |