| NPI | 1982193132 |
|---|---|
| Doing Business As | SELF |
| Entity Type | Organization |
| Authorized Contact | CHIZELLE MARGARITA FITCH Lsa 210-900-5337 |
| Organization Subpart ? | No |
| Primary Taxonomy | 246ZC0007X Specialist/Technologist, Other, Surgical Assistant (Licence: TX SA00651) |
| Enumeration Date | 2018-05-03 |
| Last Update Date | 2018-05-03 |