NPI | 1356520407 |
---|---|
Entity Type | Organization |
Authorized Contact | ALEXIS SOCKWELL President 941-914-6610 |
Organization Subpart ? | No |
Primary Taxonomy | 363AS0400X Physician Assistant, Surgical (Licence: FL P04000127074) |
Enumeration Date | 2007-10-25 |
Last Update Date | 2012-06-22 |