| NPI | 1164972964 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ANTHONY GLENN ROGERS Pricipal Investigator 561-986-2995 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363AM0700X Physician Assistant Medical (Licence: FL PA2306) |
| Enumeration Date | 2016-10-05 |
| Last Update Date | 2016-10-05 |