| NPI | 1982184826 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CARLOS J MEZA-VALENCIA Surgical Assistant Employer 888-504-6472 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363AS0400X Physician Assistant, Surgical |
| Enumeration Date | 2018-08-20 |
| Last Update Date | 2020-03-27 |