| NPI | 1932633070 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JUSTIN DOMINIC PAQUETTE Medical Director 916-341-0310 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207T00000X Neurological Surgery |
| Additional Taxonomies | 174400000X Specialist (Licence: CA A91868) |
| Enumeration Date | 2017-04-15 |
| Last Update Date | 2021-06-16 |