| NPI | 1336760297 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CHRISTINE D COLLINS Mgr 561-703-3590 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363AS0400X Physician Assistant, Surgical |
| Additional Taxonomies | 363A00000X Physician Assistant |
| Enumeration Date | 2020-05-01 |
| Last Update Date | 2020-05-04 |