| NPI | 1861141871 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SCOTT F GASPARD Owner 909-338-9880 |
| Organization Subpart ? | No |
| Primary Taxonomy | 2086S0127X Surgery, Trauma Surgery |
| Additional Taxonomies | 208600000X Surgery |
| 2086S0102X Surgery, Surgical Critical Care | |
| Enumeration Date | 2022-03-18 |
| Last Update Date | 2022-03-18 |