| NPI | 1417112590 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LYDIA ALEXANDER-COOK President 234-312-5873 |
| Organization Subpart ? | No |
| Primary Taxonomy | 208600000X Surgery |
| Additional Taxonomies | 363A00000X Physician Assistant |
| Enumeration Date | 2008-07-28 |
| Last Update Date | 2017-11-11 |