| NPI | 1003144601 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | RICK YAROSH President 954-802-6864 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363AS0400X Physician Assistant, Surgical |
| Additional Taxonomies | 363L00000X Nurse Practitioner |
| Enumeration Date | 2009-11-20 |
| Last Update Date | 2011-06-13 |