| NPI | 1134622533 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MORGAN HOLNAIDER Certified Surgical Assistant 470-336-8190 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363AS0400X Physician Assistant, Surgical |
| Enumeration Date | 2018-03-12 |
| Last Update Date | 2022-01-26 |