| NPI | 1861992117 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | GINA BACCARI Manager 210-614-8101 |
| Organization Subpart ? | No |
| Primary Taxonomy | 246ZC0007X Specialist/Technologist, Other, Surgical Assistant |
| Additional Taxonomies | 363AS0400X Physician Assistant, Surgical |
| Enumeration Date | 2018-02-13 |
| Last Update Date | 2018-02-13 |