| NPI | 1982459434 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JUSTIN DUHARTE Surgical Assistant Certified 916-952-5532 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363AS0400X Physician Assistant, Surgical |
| Additional Taxonomies | 261QA1903X Clinic/Center, Ambulatory Surgical |
| Enumeration Date | 2024-04-18 |
| Last Update Date | 2024-04-20 |