| NPI | 1932750056 |
|---|---|
| Former Legal Business Name | BRAZZALE SURGICAL ASSISTING LLC |
| Entity Type | Organization |
| Authorized Contact | ARIEL BRAZZALE CEO 219-669-1034 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner |
| Additional Taxonomies | 246ZC0007X Specialist/Technologist, Other, Surgical Assistant |
| Enumeration Date | 2019-09-20 |
| Last Update Date | 2023-08-21 |