| NPI | 1881155240 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | COLE D STATEN President 888-322-6432 |
| Organization Subpart ? | No |
| Primary Taxonomy | 246ZC0007X Specialist/Technologist, Other, Surgical Assistant |
| Enumeration Date | 2019-03-28 |
| Last Update Date | 2019-12-17 |