| NPI | 1083051593 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | GREGORY BYRNE President 800-507-8874 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant |
| Additional Taxonomies | 363L00000X Nurse Practitioner |
| Enumeration Date | 2013-05-24 |
| Last Update Date | 2013-07-31 |