| NPI | 1073743399 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JOSHUA ERNEST ROLLER President/CEO 479-445-6460 |
| Organization Subpart ? | No |
| Primary Taxonomy | 174400000X Specialist (Licence: AR E5193) |
| Additional Taxonomies | 208600000X Surgery |
| Enumeration Date | 2009-07-21 |
| Last Update Date | 2021-08-06 |