| NPI | 1902454549 |
|---|---|
| Doing Business As | SURG4LIFE |
| Entity Type | Organization |
| Authorized Contact | C PSH Manager 918-808-0583 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363AS0400X Physician Assistant, Surgical |
| Enumeration Date | 2019-08-27 |
| Last Update Date | 2019-09-19 |