| NPI | 1992272702 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JAMAL OTULA Registered Agent 972-310-7121 |
| Organization Subpart ? | No |
| Primary Taxonomy | 367H00000X Anesthesiologist Assistant |
| Additional Taxonomies | 207L00000X Anesthesiology |
| Enumeration Date | 2018-10-30 |
| Last Update Date | 2020-11-12 |