| NPI | 1407220379 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DANA SIMPSON Organizer 404-556-3543 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363AS0400X Physician Assistant, Surgical (Licence: GA 5338) |
| Enumeration Date | 2015-11-16 |
| Last Update Date | 2016-02-20 |